| NPI | 1659990109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEMEKA CUSACK Speech Language Pathologist 843-409-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |