Individual
MRS. JADE GALLOWAY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD,CCC-SLP
Contact information
Practice address
205 B CONCORD ROAD, ANDERSON, SC 29621
(864) 630-8188
Mailing address
104 BENT WILLOW WAY, EASLEY, SC 29642
(864) 630-8188
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3922
SC
Other
Enumeration date
08/21/2008
Last updated
07/18/2014
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