| NPI | 1770303141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANEIKA KEYATTA MIXSON Speech Language Pathologist 803-346-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-11 |