=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275443475
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARISE SPEECH AND LANGUAGE THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2026
-----------------------------------------------------
Last Update Date | 09/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 164 TOM CRIBB RD
-----------------------------------------------------
City | HEMINGWAY
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29554-6625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-359-0185
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 164 TOM CRIBB RD
-----------------------------------------------------
City | HEMINGWAY
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29554-6625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-359-0185
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | FREDERICK CANTEEN
-----------------------------------------------------
Credential | CCC-SLP
-----------------------------------------------------
Telephone | 843-359-0185
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------