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Individual

MISS MARY ELIZABETH HUMPHREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSP

Contact information

Practice address
114 WILLOW FORKS DR, SIMPSONVILLE, SC 29681-5971
(843) 670-2593
Mailing address
114 WILLOW FORKS DR, SIMPSONVILLE, SC 29681-5971
(843) 670-2593

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3894
SC

Other

Enumeration date
01/31/2007
Last updated
07/08/2007
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