Organization
VANTAGE SPEECH & LANGUAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY JOSEPH VINETTE II CCC, SLP (OWNER)
(843) 790-4093
Entity
Organization
Contact information
Practice address
421 BARONY ST SUITE 3, MONCKS CORNER, SC 29461-3145
(843) 790-4093
(843) 501-2297
Mailing address
421 BARONY ST SUITE 3, MONCKS CORNER, SC 29461-3145
(843) 790-4093
(843) 501-2297
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9008
—
SC
Enumeration date
06/26/2018
Last updated
01/23/2023
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