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Individual

HANNAH LONG TITUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MCD, CCC-SLP

Contact information

Practice address
118 PARKER RD, HONEA PATH, SC 29654-9589
(864) 376-4973
Mailing address
118 PARKER RD, HONEA PATH, SC 29654-9589

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5207
SC
251300000X
Local Education Agency (LEA)
5207
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1104973577
SC
Enumeration date
08/23/2013
Last updated
08/23/2013
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