Individual
MRS. BARBARA PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
S.L.P.
Contact information
Practice address
3650 COALITION DR, MYRTLE BEACH, SC 29588-6183
(843) 283-7713
Mailing address
3650 COALITION DR, MYRTLE BEACH, SC 29588-6183
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1059
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0085
—
SC
Enumeration date
05/16/2006
Last updated
07/08/2007
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