Provider Demographics
NPI:1992029078
Name:IWAI, SUZANNE JOY (MA, SLP)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:JOY
Last Name:IWAI
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:23361 MADERO
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2715
Mailing Address - Country:US
Mailing Address - Phone:949-581-8239
Mailing Address - Fax:949-859-0849
Practice Address - Street 1:23361 MADERO
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2715
Practice Address - Country:US
Practice Address - Phone:949-581-8239
Practice Address - Fax:949-859-0849
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP18131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist