Individual
MRS. TARA A GAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
108 LEIGHTON CT, SUMMERVILLE, SC 29485-8058
(843) 277-4072
Mailing address
108 LEIGHTON CT, SUMMERVILLE, SC 29485-8058
(843) 277-4072
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4655
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA5811
—
SC
Enumeration date
06/07/2010
Last updated
07/21/2022
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