Individual
MARY CLARE VAN HULLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
9565 HIGHWAY 78 STE 102, LADSON, SC 29456-4118
(843) 569-4546
(843) 569-4535
Mailing address
9565 HIGHWAY 78 STE 102, LADSON, SC 29456-4118
(843) 569-4546
(843) 569-4535
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9090
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16398015
CAQH
SC
01
—
9090
STATE LICENSE
SC
05
—
SA3027
—
SC
Enumeration date
07/08/2022
Last updated
02/21/2025
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