Organization
S.C. STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GWENDOLYN D. WILSON (DEPARTMENT CHAIR)
(803) 536-7063
Entity
Organization
Contact information
Practice address
300 COLLEGE STREET, NE, 300 COLLEG STREET, NE, ORANGEBURG, SC 29117-0001
(803) 536-8073
(803) 533-3627
Mailing address
300 COLLEGE STREET, NE, P O BOX 7427, ORANGEBURG, SC 29117-0001
(803) 536-8073
(803) 533-3627
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349987
—
SC
Enumeration date
11/07/2006
Last updated
06/18/2008
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