Individual
LORETTA B SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3937 SUNSET BLVD STE B, WEST COLUMBIA, SC 29169-2423
(803) 900-4890
(803) 931-3891
Mailing address
466 WAGNER TRL, COLUMBIA, SC 29229-7036
(860) 463-1955
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
288562
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8131
—
SC
Enumeration date
09/27/2018
Last updated
09/27/2018
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