Organization
PEDIATRIC THERAPY ACHIEVEMENTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE L BRAZELL MA, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(803) 640-3984
Entity
Organization
Contact information
Practice address
43 AVIARY LN, JOHNSTON, SC 29832-2658
(803) 640-3984
Mailing address
43 AVIARY LN, JOHNSTON, SC 29832-2658
(803) 640-3984
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3298
SC
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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