Provider Demographics
NPI:1528515087
Name:MCTYIERE, SUSAN (AUD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:MCTYIERE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MORSE RD
Mailing Address - Street 2:OHIO SCHOOL FOR THE DEAF
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1833
Mailing Address - Country:US
Mailing Address - Phone:614-728-1407
Mailing Address - Fax:614-728-1464
Practice Address - Street 1:500 MORSE RD
Practice Address - Street 2:OHIO SCHOOL FOR THE DEAF
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1833
Practice Address - Country:US
Practice Address - Phone:614-728-1407
Practice Address - Fax:614-728-1464
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01246231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist