Basic Information
Provider Information
NPI: 1689994295
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAPIR
FirstName: SUZAN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: M.A., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8717 VENICE BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900343216
CountryCode: US
TelephoneNumber: 3103377115
FaxNumber:  
Practice Location
Address1: 8929 WILSHIRE BLVD
Address2: 105
City: BEVERLY HILLS
State: CA
PostalCode: 90211
CountryCode: US
TelephoneNumber: 3103609983
FaxNumber: 3103609983
Other Information
ProviderEnumerationDate: 06/04/2010
LastUpdateDate: 07/07/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X18606CAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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