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Organization
CHARLESTON AUTISM ACADEMY
Active
Organization
CHARLESTON AUTISM ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA TODD MISENHELTER (PRESIDENT, BOARD OF TRUSTEES)
(843) 881-0330
Entity
Organization
Contact information
Practice address
480 JESSEN LN, STE D, WANDO, SC 29492-7915
(843) 881-0330
(843) 405-7020
Mailing address
480 JESSEN LN, STE D, WANDO, SC 29492-7915
(843) 881-0330
(843) 405-7020
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
3529
SC
235Z00000X
Speech-Language Pathologist
4491
SC
Other
Enumeration date
03/03/2010
Last updated
10/07/2012
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