Healthcare Provider Details

I. General information

NPI: 1225230188
Provider Name (Legal Business Name): AMY PINCKNEY M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ROSE ISLAND RD
SAINT HELENA ISLAND SC
29920-3915
US

IV. Provider business mailing address

1004 10TH ST
PORT ROYAL SC
29935-2310
US

V. Phone/Fax

Practice location:
  • Phone: 843-838-9026
  • Fax:
Mailing address:
  • Phone: 843-310-9690
  • Fax: 800-317-9690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3228
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: