| NPI | 1740501949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLA K. JOHNSON Speech Language Pathologist 803-235-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NC 9496) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 2355S0801X Specialist/Technologist Speech-Language Assistant | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2016-02-01 |