Individual
SARA MOUSAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 GRACERN RD STE 450, COLUMBIA, SC 29210-7657
(803) 667-7835
(803) 897-8179
Mailing address
720 GRACERN RD STE 450, COLUMBIA, SC 29210-7657
(803) 667-7835
(803) 897-8179
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7326
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5549
—
SC
Enumeration date
09/29/2020
Last updated
09/29/2020
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