Healthcare Provider Details

I. General information

NPI: 1699689893
Provider Name (Legal Business Name): PEARCE AND CO. PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 MELODYBROOK CT
LEXINGTON SC
29073-9772
US

IV. Provider business mailing address

422 MELODYBROOK CT
LEXINGTON SC
29073-9772
US

V. Phone/Fax

Practice location:
  • Phone: 803-645-6935
  • Fax:
Mailing address:
  • Phone: 803-645-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RAVEN P FAIR
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.A., CCC-SLP
Phone: 803-645-6935