Healthcare Provider Details

I. General information

NPI: 1003281254
Provider Name (Legal Business Name): CATHERINE HUNTER STROMBERG MCD, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2015
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 COLLEGE ST STE 220
COLUMBIA SC
29201-3917
US

IV. Provider business mailing address

1705 COLLEGE ST STE 220
COLUMBIA SC
29201-3917
US

V. Phone/Fax

Practice location:
  • Phone: 803-777-2622
  • Fax: 803-777-3081
Mailing address:
  • Phone: 803-777-2622
  • Fax: 803-777-3081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4196
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: