Provider Demographics
NPI:1427106632
Name:GALE J SINGLETARY DBA SPEECH LANGUAGE PATHOLOGY SERVICES
Entity type:Organization
Organization Name:GALE J SINGLETARY DBA SPEECH LANGUAGE PATHOLOGY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-CONTRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GALE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETARY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP-L
Authorized Official - Phone:843-509-2557
Mailing Address - Street 1:2749 STAR DR
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4515
Mailing Address - Country:US
Mailing Address - Phone:843-509-2557
Mailing Address - Fax:843-763-9595
Practice Address - Street 1:2749 STAR DR
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4515
Practice Address - Country:US
Practice Address - Phone:843-509-2557
Practice Address - Fax:843-763-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1009235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0299Medicaid
SC=========OtherTRICARE-HUMANA
SC=========OtherBLUECROSS BLUESHIELD