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NPI Code Detail

MEDICARE: MRS. ELIZABETH WARD PIERCE MSP, CCC-SLP

MEDICARE: MRS. ELIZABETH WARD PIERCE MSP, 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
1235Z00000XSpeech-Language Pathologist4199SC

General Provider Information

NPI Number : 1720274822
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH WARD PIERCE MSP, CCC-SLP
Provider Business Mailing Address
First Line : 3620 COVENANT RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4216
Country : US
Telephone Number : 803-787-3033
Fax Number : 803-787-0300
Provider Business Practice Location Address
First Line : 3620 COVENANT RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-4216
Country : US
Telephone Number : 803-787-3033
Fax Number : 803-787-0300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2007
Last Update Date : 11/07/2012

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