# THERAPLAYHOUSE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003077611
- **Authorized official:** MRS. SUSAN M PALMER MSP, CCC/SLP (SPEECH PATHOLOGIST/ INITIAL AGENT)
- **Authorized official phone:** (843) 495-6404

## Contact information

- **Practice address:** 515 FULMORE RD, LAKE CITY, SC 29560-7903
- **Practice address phone:** (843) 495-6404
- **Mailing address:** 515 FULMORE RD, LAKE CITY, SC 29560-7903
- **Mailing address phone:** (843) 495-6404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 3006 | SC | Yes |

## Other

- **Enumeration date:** 06/17/2008
- **Last updated:** 06/17/2008