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General NPI Number Information
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NPI Number | 1346578564
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Entity Type | Organization
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Legal Business Name | SPEECH REACH, INC.
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Dates
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Enumeration Date | 11/29/2009
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Last Update Date | 11/29/2009
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Provider Practice Location Address
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Address Line | 3700 CAIRNBROOK DR
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City | COLUMBIA
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State | SC
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Zip | 29210-4819
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Country | US
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Telephone | 803-447-4505
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Fax | 803-772-8606
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Provider Business Mailing Address
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Address Line | 3700 CAIRNBROOK DR
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City | COLUMBIA
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State | SC
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Zip | 29210-4819
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Country | US
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Telephone | 803-447-4505
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Fax | 803-772-8606
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIANA O MILLER
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Credential | MS, CCC-SLP
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Telephone | 803-447-4505
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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 | 2634
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License Number State | SC
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