Provider Demographics
NPI:1386983971
Name:KINEVY, SUZANNE A (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:A
Last Name:KINEVY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 WATCHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-8976
Mailing Address - Country:US
Mailing Address - Phone:412-650-8526
Mailing Address - Fax:
Practice Address - Street 1:100 TANDEM VILLAGE RD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2382
Practice Address - Country:US
Practice Address - Phone:724-743-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-03
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005580L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist