Individual
MRS. WENDY SHOCKLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
SPEECH THERAPIST
Contact information
Practice address
1132 RUTHERFORD RD, GREENVILLE, SC 29609-3927
(864) 250-0005
(864) 250-0028
Mailing address
300 NEW TARLETON WAY, GREER, SC 29650-3249
(864) 968-1193
(864) 250-0028
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3190
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0376
—
SC
Enumeration date
01/18/2006
Last updated
07/09/2007
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