Individual
KYLIE LYN SERVELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, SLP
Contact information
Practice address
400 WEBBER RD, SPARTANBURG, SC 29307-2400
(864) 579-7004
Mailing address
536 OLD HOWELL RD, GREENVILLE, SC 29615-1969
(864) 244-3626
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.014705
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146.014705
STATE OF ILLINOIS PROFESSIONAL LICENSE
IL
01
—
7281
SOUTH CAROLINA DEPARTMENT OF LABOR, LICENSING, AND REGULATION
SC
Enumeration date
08/30/2018
Last updated
12/21/2021
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