Provider Demographics
NPI:1326327941
Name:URRY, SUSAN DIANE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DIANE
Last Name:URRY
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 1:2400 DANBURY DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5424
Mailing Address - Country:US
Mailing Address - Phone:859-539-0321
Mailing Address - Fax:
Practice Address - Street 1:2400 DANBURY DR
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5424
Practice Address - Country:US
Practice Address - Phone:859-539-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3780235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist