Organization
PALMETTO SPEECH & LANGUAGE ASSOC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENA C RANDOLPH MA, CCC-SLP (OWNER)
(843) 388-9990
Entity
Organization
Contact information
Practice address
3185 AZALEA DRIVE, NORTH CHARLESTON, SC 29405
(843) 388-9990
(843) 388-0349
Mailing address
1150 HUNGRYNECK BLVD, SUITE C-364, MOUNT PLEASANT, SC 29464
(843) 388-9990
(843) 388-0349
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3120
SC
Other
Enumeration date
08/08/2008
Last updated
08/08/2008
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