Individual
ELISABETH BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2431 US-501, CONWAY, SC 29526
(843) 575-8768
Mailing address
PO BOX 70387, MYRTLE BEACH, SC 29572-0025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8830
SC
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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