Provider Demographics
NPI:1083965032
Name:CARVER, SUSANNE LOUISE (HAS, BC-HIS)
Entity type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:LOUISE
Last Name:CARVER
Suffix:
Gender:F
Credentials:HAS, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3353 DOUBLE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3833
Mailing Address - Country:US
Mailing Address - Phone:904-744-3526
Mailing Address - Fax:
Practice Address - Street 1:6373 YOUNGERMAN CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6609
Practice Address - Country:US
Practice Address - Phone:904-573-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-29
Last Update Date:2012-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2720237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist