MEDICARE: WHITNEY MOURLAM

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	2355S0801X	Speech-Language Assistant		SC

General Provider Information

NPI Number	:	1952254690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY MOURLAM

Provider Business Mailing Address
First Line	:	1563 SAM RITTENBERG BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4248
Country	:	US
Telephone Number	:	843-277-2411
Fax Number	:	855-504-4089

Provider Business Practice Location Address
First Line	:	1563 SAM RITTENBERG BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4248
Country	:	US
Telephone Number	:	843-277-2411
Fax Number	:	855-504-4089

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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Directions to “ WHITNEY MOURLAM ” Practice Location

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