Individual
ALEXIS DEAN PEDIGO MAYBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
1900 AUGUSTA ST, SUITE 2500, GREENVILLE, SC 29605
(864) 370-0131
Mailing address
PO BOX 8483, GREENVILLE, SC 29604-8483
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5841
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14099378
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
5841
SC LLR BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
SC
Enumeration date
06/13/2017
Last updated
11/01/2024
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