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Organization

BURNING BUSH SPEECH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MELISSA MARIE WAGNER M.S. CCC-SLP (CEO/OWENER)
(803) 339-0135
Entity
Organization

Contact information

Practice address
9948 JACK NICKLAUS DR, LANCASTER, SC 29720-0445
(803) 339-0135
(803) 262-2039
Mailing address
2736 CELANESE RD # 3, ROCK HILL, SC 29732-8440
(610) 816-8489
(803) 262-2039

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
06/25/2025
Last updated
07/05/2025
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