Organization
CHARLESTON AUTISM ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MISENHELTER (BOARD PRESIDENT)
(843) 881-0330
Entity
Organization
Contact information
Practice address
480 JESSEN LN STE D, WANDO, SC 29492-7915
(843) 881-0330
(843) 405-7020
Mailing address
480 JESSEN LN STE D, WANDO, SC 29492-7915
(843) 881-0330
(843) 405-7020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3529
SC
235Z00000X
Speech-Language Pathologist
Primary
4491
SC
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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