Organization
ABA OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI PAKURAR BCBA (OWNER)
(843) 297-8470
Entity
Organization
Contact information
Practice address
828 WAPPOO RD, CHARLESTON, SC 29407-5865
(843) 297-8470
Mailing address
PO BOX 21385, CHARLESTON, SC 29413-1385
(843) 297-8470
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10QTDU8FHE9DAH4
—
SC
Enumeration date
08/11/2016
Last updated
08/11/2016
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