MEDICARE: DEANDRA DERONIQUE MORRISON CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	5672	SC

General Provider Information

NPI Number	:	1710378278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANDRA DERONIQUE MORRISON CCC-SLP

Provider Business Mailing Address
First Line	:	428 CALABASH LN
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-4265
Country	:	US
Telephone Number	:	843-669-3502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 N KINGS ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1916
Country	:	US
Telephone Number	:	803-699-4111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	06/01/2026

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Directions to “ DEANDRA DERONIQUE MORRISON CCC-SLP” Practice Location

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