Individual
MRS. SUSAN SULLIVAN CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.CCC SLP
Contact information
Practice address
4171 WESTPORT RD, LOUISVILLE, KY 40207-2739
(502) 896-8868
(502) 895-8794
Mailing address
4171 WESTPORT RD, LOUISVILLE, KY 40207-2739
(502) 896-8868
(502) 895-8794
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0328
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048974
ANTHEM ID
KY
Enumeration date
09/20/2006
Last updated
07/09/2007
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