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1013193820
GENEA DESHIELDS DESHIELDS BOYKIN
IRMO, SC
NPI
1013193820
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Former Name
GENEA OLISHA DESHIELDS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: SC 3951)
Enumeration Date
2008-01-11
Last Update Date
2008-01-11
Business Address
Mrs. GENEA DESHIELDS DESHIELDS BOYKIN MSP CCC SLP
355 RIDGE RUN TRAIL
IRMO, SC 29063
Phone number: 803-271-2364
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Mailing Address
Mrs. GENEA DESHIELDS DESHIELDS BOYKIN MSP CCC SLP
355 RIDGE RUN TRAIL
IRMO, SC 29063
Phone number: 803-271-2364
Copy
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