Individual
SANDRA MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
414 S PINE ST, WALHALLA, SC 29691-2146
(864) 886-4480
Mailing address
414 S PINE ST, WALHALLA, SC 29691-2146
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4921
SC
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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