Individual
SUSAN ROBERTA LOOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
10440 SHAKER DR STE 209, COLUMBIA, MD 21046-2339
(443) 691-6415
Mailing address
10440 SHAKER DR STE 209, COLUMBIA, MD 21046-2339
(443) 691-6415
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01910
MD
235Z00000X
Speech-Language Pathologist
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Other
Enumeration date
11/13/2015
Last updated
04/29/2016
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