Individual
SHANEIKA KEYATTA MIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4920 HARD SCRABBLE RD APT 216, COLUMBIA, SC 29229-9366
(803) 346-9019
Mailing address
4920 HARD SCRABBLE RD APT 216, COLUMBIA, SC 29229-9366
(803) 346-9019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8140
SC
Other
Enumeration date
04/27/2024
Last updated
04/27/2024
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