Most Relevant Information
Provider Data
| NPI Number: | 1003078809 |
| Provider Name: | SUSAN LAWRENCE-DEDERICH MACCCSLP/L,TSHH |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 05586-1 |
Most Important Dates
| Enumeration Date: | 07/02/2008 |
| Last Updated: | 07/02/2008 |
Provider Practice Location
299 LAKEFRONT BLVD
BUFFALO
NY
142024325
Practice Location Phone/Fax
| Phone: | 7168534733 |
| Fax: |
Provider Mailing Location
299 LAKEFRONT BLVD
BUFFALO
NY
142024325
Provider Mailing Phone/Fax
| Phone: | 7168534733 |
| Fax: |