Individual
MS. LAUREN LEA WICKLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.P., CCC-SLP
Contact information
Practice address
23 ROCK CREEK DR, GREENVILLE, SC 29605-1123
(864) 918-3195
Mailing address
23 ROCK CREEK DR, GREENVILLE, SC 29605-1123
(864) 918-3195
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5582
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA1567
—
SC
Enumeration date
06/30/2015
Last updated
07/13/2020
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