Individual
MISS MICHELLE GEORGETTE KNUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
1501 E GREENVILLE ST, ANDERSON, SC 29621-2004
(864) 226-8356
Mailing address
437 WALDEN CREEK WAY, GREENVILLE, SC 29615-6714
(803) 446-3351
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3612
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12094682
ASHA CERTIFICATION
SC
01
—
3612
STATE LICENSURE
SC
Enumeration date
10/04/2006
Last updated
07/08/2007
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