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Individual

MS. SUSAN E SHOULDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S./ CCC-SLP

Contact information

Practice address
1123 N BARDSTOWN RD, SUITE #2, MT WASHINGTON, KY 40047-7843
(502) 472-1194
Mailing address
PO BOX 91286, LOUISVILLE, KY 40291-0286
(502) 472-1194

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
222Q00000X
Developmental Therapist
224Z00000X
Occupational Therapy Assistant
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
3419
KY
235Z00000X
Speech-Language Pathologist
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
11/23/2007
Last updated
02/07/2020
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