Healthcare Provider Details

I. General information

NPI: 1881036572
Provider Name (Legal Business Name): SCHOOL DISTRICT OF NEWBERRY COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 S WHEELER AVE
PROSPERITY SC
29127-9346
US

IV. Provider business mailing address

381 S WHEELER AVE
PROSPERITY SC
29127-9346
US

V. Phone/Fax

Practice location:
  • Phone: 803-364-2321
  • Fax:
Mailing address:
  • Phone: 803-364-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number4694
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KAREN T. FISHER
Title or Position: SPEECH THERAPIST
Credential: CCC-SLP
Phone: 803-364-2321