Individual
SUZANNE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
N1W31097 WILDWOOD TRL, DELAFIELD, WI 53018-2958
(262) 264-0506
Mailing address
N1W31097 WILDWOOD TRL, DELAFIELD, WI 53018-2958
(262) 264-0506
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
627-154
WI
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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