Individual
MRS. MARY ELIZABETH DEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,SLP, CCC
Contact information
Practice address
120 KARR CT, LEXINGTON, SC 29072-8725
(803) 957-1982
Mailing address
120 KARR CT, LEXINGTON, SC 29072-8725
(803) 957-1982
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1502
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1502
SLP LICENSE
SC
Enumeration date
09/29/2010
Last updated
09/29/2010
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