Individual
SUSAN VANESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,C.C.C.
Contact information
Practice address
2555 BERKSHIRE PKWY, SUITE B, CLIVE, IA 50325-4646
(515) 987-8835
(515) 987-4637
Mailing address
4590 DEERWOOD CIR, JOHNSTON, IA 50131-1343
(515) 201-3551
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
00073
IA
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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