Individual
SUSAN C. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Mailing address
2915 NORTH 4TH STREET, FLAGSTAFF, AZ 86004
(928) 779-1679
(928) 779-2822
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1286
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
535362
—
AZ
01
—
716126
ASHA ID #
—
Enumeration date
01/15/2007
Last updated
07/07/2020
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