Individual
MISS AKILAH FETHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
406 W BROAD ST, IVA, SC 29655-9765
(864) 348-7433
Mailing address
406 W BROAD ST, IVA, SC 29655-9765
(864) 348-7433
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4532
SC
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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