Individual
LAURA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 ALEXANDER ST, MAULDIN, SC 29662-2413
(864) 438-0990
Mailing address
1230 ALEXANDER ST, MAULDIN, SC 29662-2413
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5733
SC
Other
Enumeration date
03/06/2014
Last updated
10/23/2015
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