Individual
SUSAN DALE CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
26420 KENSINGTON PL, STE C, DAPHNE, AL 36526-5120
(251) 517-0355
Mailing address
26420 KENSINGTON PL, STE C, DAPHNE, AL 36526-5120
(251) 517-0355
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3666
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70CS07FL03090003002
—
FL
Enumeration date
09/06/2013
Last updated
03/08/2017
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