Individual
ANITA A RISDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(864) 331-1350
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22003966A
IN
235Z00000X
Speech-Language Pathologist
Primary
5831
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200714470A
—
IN
Enumeration date
05/17/2007
Last updated
12/12/2016
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