Organization
CRESCENT CHILD DEVELOPMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARA MARIE GREGORI MSP, CCC-SLP, BCBA (DIRECTOR)
(843) 813-1538
Entity
Organization
Contact information
Practice address
966 GOVERNORS CT, MOUNT PLEASANT, SC 29464-9257
(843) 813-1538
(888) 813-3318
Mailing address
966 GOVERNORS CT, MOUNT PLEASANT, SC 29464-9257
(843) 813-1538
(888) 813-3318
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
235Z00000X
Speech-Language Pathologist
2212
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EN1160
—
SC
Enumeration date
08/27/2011
Last updated
04/10/2012
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