Provider Demographics
NPI:1386311744
Name:UMENHOFER, BAILEY W (SLP)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:W
Last Name:UMENHOFER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MARSHELLEN DR STE A
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6900
Mailing Address - Country:US
Mailing Address - Phone:843-379-5333
Mailing Address - Fax:843-379-5338
Practice Address - Street 1:14 MARSHELLEN DR STE A
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6900
Practice Address - Country:US
Practice Address - Phone:843-379-5333
Practice Address - Fax:843-379-5338
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty