Individual
SVETLANA KOZLOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
698 HOWARD ST, SPARTANBURG SCHOOL DISTRICT 7, SPARATANBURG, SC 29303
(864) 596-8491
(864) 596-8495
Mailing address
PO BOX 970, SPARTANBURG, SC 29304-0970
(864) 596-8491
(864) 596-8495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5700
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5700
SC DEPARTMENT OF LABOR, LICENSING AND REGULATION
SC
Enumeration date
12/17/2015
Last updated
12/17/2015
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