Organization
COMMUNICATION STATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA TANNER BRADLEY CCC-SLP (SPEECH PATHOLOGIST/LEAD CLINICIAN)
(803) 707-3264
Entity
Organization
Contact information
Practice address
1064 OAKLANE DR, ORANGEBURG, SC 29115-8119
(803) 707-3264
Mailing address
1064 OAKLANE DR, ORANGEBURG, SC 29115
(803) 707-3264
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023172376
—
SC
Enumeration date
10/15/2009
Last updated
10/15/2009
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