| NPI | 1124445705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE J MANTHEY Office Manager 803-661-5033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 4676) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2021-09-07 |