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Individual
SUZANN MICHELLE COLTHURST
Active
Individual
SUZANN MICHELLE COLTHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146009971
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
537460031
MEDICARE PTAN
IL
01
—
P00991695
RR MEDICARE
IL
Enumeration date
05/24/2011
Last updated
01/27/2012
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