Individual
MRS. AUTUMN HOPE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
355 RIDGE RUN TRL, IRMO, SC 29063-8667
(803) 271-2364
Mailing address
355 RIDGE RUN TRL, IRMO, SC 29063-8667
(803) 271-2364
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4299
SC
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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