Provider Demographics
NPI:1386476992
Name:CAMPOS, SABRINA (SLP-A)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HARRILL CT
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3727
Mailing Address - Country:US
Mailing Address - Phone:843-200-9600
Mailing Address - Fax:843-872-0511
Practice Address - Street 1:13 HARRILL CT
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3727
Practice Address - Country:US
Practice Address - Phone:843-200-9600
Practice Address - Fax:843-872-0511
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89282355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty