Individual
ALICIA SHANTA SMALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1013 N KING ST, APT 200B, COLUMBIA, SC 29223
(803) 312-5533
Mailing address
10120 TWO NOTCH RD, STE 2 PMB 212, COLUMBIA, SC 29223-4395
(803) 312-5533
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7732
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7732
SC LLR
SC
Enumeration date
06/01/2022
Last updated
06/01/2022
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