Individual
TARA MARIE GREGORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP, BCBA
Contact information
Practice address
966 GOVERNORS CT, MOUNT PLEASANT, SC 29464-9257
(843) 813-1538
(843) 884-6190
Mailing address
966 GOVERNORS CT, MOUNT PLEASANT, SC 29464-9257
(843) 813-1538
(843) 888-8133
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
235Z00000X
Speech-Language Pathologist
Primary
2212
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EXG324
—
SC
05
—
SA0412
—
SC
Enumeration date
04/16/2007
Last updated
04/10/2012
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