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NPI Code Detail

MEDICARE: COMMUNICATION COTTAGE THERAPY LLC

MEDICARE: COMMUNICATION COTTAGE THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1295311561
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNICATION COTTAGE THERAPY LLC
Provider Business Mailing Address
First Line : 5000 HIGHWAY 17 BYP S
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-4500
Country : US
Telephone Number : 843-318-9207
Fax Number : 843-582-0259
Provider Business Practice Location Address
First Line : 5000 HIGHWAY 17 BYP S
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-4500
Country : US
Telephone Number : 843-318-9207
Fax Number : 843-582-0259
Authorized Official
Title or Position : OWNER, SPEECH LANGUAGE PATHOLOGIST
Name : MRS. KRISTIN M WEINGART
Credential : MS CCC-SLP
Telephone Number : 843-252-0033
Provider Enumeration Date : 03/18/2021
Last Update Date : 12/15/2023

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Directions to “COMMUNICATION COTTAGE THERAPY LLC ” Practice Location

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