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General NPI Number Information
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NPI Number | 1326975475
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Entity Type | Organization
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Legal Business Name | MAGNOLIA SPEECH AND LANGUAGE, LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 208 GRAND PALM LN
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City | SUMMERVILLE
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State | SC
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Zip | 29485-5859
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Country | US
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Telephone | 843-695-9886
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Fax | 843-790-2303
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Provider Business Mailing Address
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Address Line | 717 OLD TROLLEY RD. STE 6, BOX 225
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City | SUMMERVILLE
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State | SC
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Zip | 29485
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Country | US
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Telephone | 843-695-9886
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Fax | 843-790-2303
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Authorized Official
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Title or Position | SLP
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Name | ELIZABETH EZZO
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Credential | MS
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Telephone | 772-485-1742
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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 |
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License Number State |
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