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General NPI Number Information
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NPI Number | 1063586493
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Entity Type | Organization
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Legal Business Name | PALMETTO LANGUAGE & SPEECH CENTER, LLC
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Dates
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Enumeration Date | 11/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 109 A VISTA OAKS DRIVE
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City | LEXINGTON
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State | SC
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Zip | 29072
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Country | US
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Telephone | 803-356-9833
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Fax | 803-996-0548
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Provider Business Mailing Address
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Address Line | 109 A VISTA OAKS DRIVE
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City | LEXINGTON
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State | SC
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Zip | 29072
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Country | US
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Telephone | 803-356-9833
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Fax | 803-996-0548
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Authorized Official
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Title or Position | CENTER DIRECTOR
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Name | MS. JUNE K MARANVILLE
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Credential | MSP, CCC-SLP
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Telephone | 803-356-9833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1522
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License Number State | SC
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