Provider Demographics
NPI:1588376644
Name:SPEECH-LANGUAGE PATHOLOGY ASSOCIATES OF SOUTH CAROLINA
Entity type:Organization
Organization Name:SPEECH-LANGUAGE PATHOLOGY ASSOCIATES OF SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSR CCC-SLP
Authorized Official - Phone:803-587-0799
Mailing Address - Street 1:269 BLACK PINE CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-6914
Mailing Address - Country:US
Mailing Address - Phone:803-587-0799
Mailing Address - Fax:
Practice Address - Street 1:269 BLACK PINE CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-6914
Practice Address - Country:US
Practice Address - Phone:803-587-0799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech