Individual
KATELYN MYRACLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
9701 PATRIOT BLVD, LADSON, SC 29456-8501
(843) 695-2979
Mailing address
5016 WHITE CEDAR RD, LADSON, SC 29456-8539
(573) 275-7311
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
5712
TN
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/05/2016
Last updated
01/04/2023
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