Individual
AMY E IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4201 CAROLINA EXCHANGE DR, SUITE 102, MYRTLE BEACH, SC 29579-4394
(843) 455-7505
(866) 571-1014
Mailing address
PO BOX 1523, LITTLE RIVER, SC 29566-1523
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3459
SC
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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