Individual
MRS. STACY GARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
1920 COTTONWOOD DR, AIKEN, SC 29803-5783
(803) 215-7788
(803) 642-0674
Mailing address
1920 COTTONWOOD DR, AIKEN, SC 29803-5783
(803) 215-7788
(803) 642-0674
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2120
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0722
—
SC
Enumeration date
03/03/2007
Last updated
07/08/2007
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