Individual
SUSAN NELL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
LIFESCAPE ABLE KIDS, 2524 GLENN AVE., SIOUX CITY, SD 51106
(712) 226-2253
(712) 226-2254
Mailing address
LIFESCAPE ABLE KIDS, 2524 GLENN AVE, SIOUX CITY, SD 51106
(712) 226-2253
(712) 226-2254
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
10681
IA
235Z00000X
Speech-Language Pathologist
Primary
801-SLP
SD
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/04/2018
Last updated
02/11/2021
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