Provider Demographics
NPI:1285871483
Name:SUELY CORP
Entity type:Organization
Organization Name:SUELY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:WINITSKY
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:561-702-3965
Mailing Address - Street 1:10105 AVENIDA DEL RIO
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2423
Mailing Address - Country:US
Mailing Address - Phone:561-702-3965
Mailing Address - Fax:561-638-5880
Practice Address - Street 1:10105 AVENIDA DEL RIO
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2423
Practice Address - Country:US
Practice Address - Phone:561-702-3965
Practice Address - Fax:561-638-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-10
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty