Provider Demographics
NPI:1114160587
Name:REINHARDT, SUSAN E
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:E
Other - Last Name:REINHARDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP MS CCC
Mailing Address - Street 1:36 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2312
Mailing Address - Country:US
Mailing Address - Phone:617-739-6565
Mailing Address - Fax:617-739-4142
Practice Address - Street 1:36 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2312
Practice Address - Country:US
Practice Address - Phone:617-739-6565
Practice Address - Fax:617-739-4142
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1186235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist