| NPI | 1306352059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE GREEN Speech Language Pathologist 803-465-4331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 6068) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2018-04-16 |