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General NPI Number Information
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NPI Number | 1427087675
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Entity Type | Organization
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Legal Business Name | UNIVERSAL LANGUAGE CENTER
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4824 SMALLWOOD RD SUITE #184
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City | COLUMBIA
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State | SC
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Zip | 29223-3232
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Country | US
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Telephone | 803-432-0188
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Fax | 803-462-9976
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Provider Business Mailing Address
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Address Line | 4824 SMALLWOOD RD SUITE #184
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City | COLUMBIA
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State | SC
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Zip | 29223-3232
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Country | US
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Telephone | 803-432-0188
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Fax | 803-462-9976
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Authorized Official
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Title or Position | BILINGUAL SPEECH- LANGUAGE PATHOLOG
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Name | RAMONA MACK
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Credential | M.A., CCC-SLP
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Telephone | 803-462-0188
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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 | 3020
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License Number State | SC
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