Individual
MADISON LAURYNN VICENDESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1536 FORDING ISLAND RD, HILTON HEAD ISLAND, SC 29926-1120
(843) 837-2080
Mailing address
1 GLOUCESTER RD APT 1902, HILTON HEAD ISLAND, SC 29928-0809
(443) 896-6292
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7758
SC
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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