Provider Demographics
NPI:1063885341
Name:GARCIA, SUSANNE VIGH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:VIGH
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 PUEBLO CT
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3046
Mailing Address - Country:US
Mailing Address - Phone:281-673-9511
Mailing Address - Fax:713-779-0204
Practice Address - Street 1:2610 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5661
Practice Address - Country:US
Practice Address - Phone:713-995-9292
Practice Address - Fax:713-779-0204
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX392402355S0801X
TX116803235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant