Individual
MRS. ANGELA BOLAND CARRAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
134 ZION CHURCH RD, PROSPERITY, SC 29127-9296
(803) 364-9975
Mailing address
134 ZION CHURCH RD, PROSPERITY, SC 29127-9296
(803) 364-9975
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4481
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4929
—
SC
Enumeration date
02/26/2010
Last updated
02/26/2010
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