Individual
MRS. MARY HOLSTEIN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M ED CCC SLP
Contact information
Practice address
208 MASON CROFT DRIVE, SUMTER, SC 29150
(803) 773-1893
Mailing address
208 MASON CROFT DRIVE, SUMTER, SC 29150
(803) 773-1893
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
220
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0057
—
SC
Enumeration date
11/17/2006
Last updated
07/08/2007
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