Individual
AUTUMN R. HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCCSLPCOMIBCLC
Contact information
Practice address
345 PRADO WAY, GREENVILLE, SC 29607-6512
(864) 383-8634
(864) 383-8633
Mailing address
345 PRADO WAY STE B, GREENVILLE, SC 29607-6512
(864) 383-8634
(864) 383-8633
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
235Z00000X
Speech-Language Pathologist
Primary
5607
SC
Other
Enumeration date
08/13/2013
Last updated
04/02/2020
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