Healthcare Provider Details

I. General information

NPI: 1952572448
Provider Name (Legal Business Name): TRI-COUNTY SPEECH PATHOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 WATERFORD PKWY
ORANGEBURG SC
29118-9067
US

IV. Provider business mailing address

226 WATERFORD PKWY
ORANGEBURG SC
29118-9067
US

V. Phone/Fax

Practice location:
  • Phone: 803-531-3459
  • Fax:
Mailing address:
  • Phone: 803-531-3459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number406
License Number StateSC

VIII. Authorized Official

Name: MS. DEBRA FRISHBERG
Title or Position: DIRECTOR
Credential: MA,CCC-SLP
Phone: 803-531-3459