Basic Information
| Provider Information | |||||||||
| NPI: | 1184000127 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KASLO | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | M.S., C.C.C.-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1113 STANDISH CIR | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245012227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342386952 | ||||||||
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| Practice Location | |||||||||
| Address1: | 173 BROCKMAN PARK DR | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245212583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349462850 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2015 | ||||||||
| LastUpdateDate: | 07/31/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2202003204 | VA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.