Basic Information
Provider Information
NPI: 1477723922
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SKLANEY
FirstName: SUZANNE
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SAINCLAIR
OtherFirstName: SUZANNE
OtherMiddleName: SKLANEY
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: M.S.
OtherLastNameType: 1
Mailing Information
Address1: 10 N GREENE ST
Address2: VAMHCS AUDIOLOGY
City: BALTIMORE
State: MD
PostalCode: 212011524
CountryCode: US
TelephoneNumber: 4106057000
FaxNumber: 4106057702
Practice Location
Address1: 10 N GREENE ST
Address2: VAMHCS AUDIOLOGY
City: BALTIMORE
State: MD
PostalCode: 212011524
CountryCode: US
TelephoneNumber: 4106057000
FaxNumber: 4106057702
Other Information
ProviderEnumerationDate: 03/11/2008
LastUpdateDate: 09/13/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAT000718LPAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


Home