Individual
MRS. JILL GUNNELLS TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
404 JAY ST, BAMBERG, SC 29003-2429
(803) 245-3742
Mailing address
404 JAY ST, BAMBERG, SC 29003-2429
(803) 245-3742
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3590
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA 0664
—
SC
Enumeration date
04/01/2008
Last updated
04/01/2008
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