Organization
JAN HAGWOOD COCKE, M.A., CCC-SLP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN HAGWOOD COCKE M.A. CCC-SLP (OWNER)
80337487459
Entity
Organization
Contact information
Practice address
3221 PLUM CIR, ORANGEBURG, SC 29118-3148
(803) 378-7459
(803) 536-4922
Mailing address
3221 PLUM CIR, ORANGEBURG, SC 29118-3148
(803) 378-7459
(803) 536-4922
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3546
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0548
—
SC
Enumeration date
11/17/2015
Last updated
11/17/2015
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