Individual
KRYSTINA MANTZOURANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2685 LEEDS AVE, NORTH CHARLESTON, SC 29405-6861
(843) 529-3130
Mailing address
1575 NANTAHALA BLVD, MOUNT PLEASANT, SC 29464-9753
(757) 642-1452
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/01/2016
Last updated
08/11/2019
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