Provider Demographics
NPI:1740807957
Name:SUGGS, AMY KATHLEEN CONN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KATHLEEN CONN
Last Name:SUGGS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18822 RIVER FALLS DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8856
Mailing Address - Country:US
Mailing Address - Phone:704-237-3025
Mailing Address - Fax:
Practice Address - Street 1:18822 RIVER FALLS DR
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8856
Practice Address - Country:US
Practice Address - Phone:704-237-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10508235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty