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Organization

ASPIRE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROCHELLE R ALTMAN ED.S., M.S. (EXECUTIVE DIRECTOR/BCBA)
(843) 628-2935
Entity
Organization

Contact information

Practice address
222 REDBANK RD, GOOSE CREEK, SC 29445
(843) 628-2935
(843) 628-2935
Mailing address
PO BOX 1667, GOOSE CREEK, SC 29443
(843) 628-2935
(843) 628-2935

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-09-5230
SC
103K00000X
Behavior Analyst
Primary
1-09-52301-10-7178,1
103TS0200X
School Psychologist
1052
SC
235Z00000X
Speech-Language Pathologist
4183
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
EXG313
SC
Enumeration date
05/20/2009
Last updated
06/12/2012
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