Individual
VISTA SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2825 CARTER RD, SUMTER, SC 29150-1712
(803) 469-7007
Mailing address
1259 ASHLEY ST, ORANGEBURG, SC 29115-3609
(803) 387-8878
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5779
SC
Other
Enumeration date
06/04/2016
Last updated
06/06/2016
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