Provider Demographics
NPI:1962175950
Name:ARROYO OTERO, GIANNA CAROLINA
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:CAROLINA
Last Name:ARROYO OTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 GARLINGTON RD STE B5
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4621
Mailing Address - Country:US
Mailing Address - Phone:864-417-8423
Mailing Address - Fax:
Practice Address - Street 1:319 GARLINGTON RD STE B5
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4621
Practice Address - Country:US
Practice Address - Phone:864-417-8423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7693235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty