Individual
AMANDA SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
815 JONESVILLE RD, SIMPSONVILLE, SC 29681-4504
(561) 400-0871
Mailing address
301 HILLCREST DR, LAURENS, SC 29360-2343
(864) 984-3968
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7070
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA2272
—
SC
Enumeration date
10/02/2019
Last updated
10/19/2021
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