| NPI | 1184870206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA C RANDOLPH Owner 843-388-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: SC 3120) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |