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General NPI Number Information
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NPI Number | 1124465455
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Entity Type | Organization
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Legal Business Name | SCHOOL DISTRICT OF NEWBERRY COUNTY
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 1406 BOUNDARY ST
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City | NEWBERRY
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State | SC
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Zip | 29108-3828
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Country | US
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Telephone | 803-321-2616
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Fax | 803-321-2605
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Provider Business Mailing Address
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Address Line | 376 HOLLY POINT LN
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City | PROSPERITY
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State | SC
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Zip | 29127-7684
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. JENNIFER MCCULLOUGH
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Credential | CCC-SLP
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Telephone | 803-321-2616
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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 | 3109
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License Number State | SC
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