Individual
MARY BRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 OLD BARN RD, BEAUFORT, SC 29907-1118
(330) 564-5807
Mailing address
6 OLD BARN RD, BEAUFORT, SC 29907-1118
(330) 564-5807
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP11144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14053220
ASHA CERTIFICATE OF CLINICAL COMPETENCE
—
01
—
SP11144
SPEECH LANGUAGE PATHOLOGY
OH
Enumeration date
09/05/2022
Last updated
09/05/2022
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