Individual
MRS. SUSAN M. SUPSURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.CCC/SLP
Contact information
Practice address
2233 DEERFIELD DR, FORT MILL, SC 29715-6941
(803) 548-2527
Mailing address
2233 DEERFIELD DR, FORT MILL, SC 29715-6941
(803) 548-2527
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3966
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0719
—
SC
Enumeration date
07/04/2006
Last updated
05/25/2013
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