Individual
ELIZABETH MICHELLE MCGILLICUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
4000 MABELINE RD, HANAHAN, SC 29410-4651
(843) 553-3290
Mailing address
515 ROBERT DANIEL DR APT 5104, DANIEL ISLAND, SC 29492-7346
(254) 644-7103
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008572
VA
Other
Enumeration date
09/22/2017
Last updated
12/20/2018
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