Organization
CAROLINA MILESTONES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA GAY MS CCC-SLP (OWNER)
(843) 277-4072
Entity
Organization
Contact information
Practice address
108 LEIGHTON CT, SUMMERVILLE, SC 29485-8058
(843) 277-4072
(843) 410-5706
Mailing address
108 LEIGHTON CT, SUMMERVILLE, SC 29485-8058
(843) 277-4072
(843) 410-5706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA1181
—
SC
Enumeration date
09/03/2020
Last updated
09/03/2020
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