Provider Demographics
NPI:1194965350
Name:EMPOWER TO COMMUNICATE
Entity type:Organization
Organization Name:EMPOWER TO COMMUNICATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSP CCC-SLP
Authorized Official - Phone:803-206-7690
Mailing Address - Street 1:910 MARTHA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5032
Mailing Address - Country:US
Mailing Address - Phone:803-206-7690
Mailing Address - Fax:
Practice Address - Street 1:910 MARTHA ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-5032
Practice Address - Country:US
Practice Address - Phone:803-206-7690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-01
Last Update Date:2009-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty