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NPI Code Detail

MEDICARE: KATELYN BOARD MS CCC-SLP

MEDICARE: KATELYN BOARD MS 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 Pathologist

General Provider Information

NPI Number : 1972230548
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN BOARD MS CCC-SLP
Provider Business Mailing Address
First Line : 2685 CELANESE RD STE 105
Second Line :
City : ROCK HILL
State : SC
Zip : 29732
Country : US
Telephone Number : 803-372-8415
Fax Number :
Provider Business Practice Location Address
First Line : 2685 CELANESE RD STE 105
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-2994
Country : US
Telephone Number : 803-661-5033
Fax Number : 864-643-2327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2022
Last Update Date : 01/24/2024

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Directions to “ KATELYN BOARD MS CCC-SLP” Practice Location

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