Provider Demographics
NPI:1871055301
Name:SUDER, NANCY HIGGS (MS-CCC-SLP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:HIGGS
Last Name:SUDER
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 1:1511 FAIRMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2124
Mailing Address - Country:US
Mailing Address - Phone:443-974-5735
Mailing Address - Fax:
Practice Address - Street 1:701 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1399
Practice Address - Country:US
Practice Address - Phone:410-887-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist