Provider Demographics
NPI:1992925333
Name:INGLE, SUZANNE MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:INGLE
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 1:2115 GRIBBLE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41017-9201
Mailing Address - Country:US
Mailing Address - Phone:859-466-3398
Mailing Address - Fax:859-282-4620
Practice Address - Street 1:2115 GRIBBLE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41017-9201
Practice Address - Country:US
Practice Address - Phone:859-466-3398
Practice Address - Fax:859-282-4620
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1819235Z00000X
KY142570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist