Individual
KRISTI COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
5162
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5162
STATE LICENSE
SC
Enumeration date
09/09/2019
Last updated
09/09/2019
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