Organization
SUMMERVILLE SPEECH THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELEANOR GRAY SMITH CCC-SLP (PRESIDENT)
(843) 856-4949
Entity
Organization
Contact information
Practice address
1551 BEN SAWYER BLVD, UNIT 1-E, MT PLEASANT, SC 29464-5500
(843) 856-4949
Mailing address
PO BOX 1342, SUMMERVILLE, SC 29484-1342
(843) 856-4949
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
312
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3442
—
SC
Enumeration date
12/27/2006
Last updated
08/22/2020
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