Individual
BERNADETTE RUBANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC/SLP
Contact information
Practice address
128 HIGHWAY 17 S, NORTH MYRTLE BEACH, SC 29582-3118
(843) 280-3755
(843) 280-3768
Mailing address
4373 WINGED FOOT COURT, MYRTLE BEACH, SC 29579
(843) 236-0940
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3687
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA1241
—
SC
Enumeration date
05/20/2008
Last updated
05/16/2012
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