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General NPI Number Information
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NPI Number | 1528843240
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Entity Type | Organization
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Legal Business Name | SPROUTING SPEECH AND LANGUAGE LLC
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 1244 CENTRAL AVE STE A
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City | SUMMERVILLE
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State | SC
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Zip | 29483-3148
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Country | US
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Telephone | 843-437-8917
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Fax | 843-887-8075
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Provider Business Mailing Address
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Address Line | 147 BERWICK DR
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City | SUMMERVILLE
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State | SC
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Zip | 29483-8153
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Country | US
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Telephone | 843-437-8917
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH PATHOLOGIST
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Name | SEAN WILLIAM LEFFERTS
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Credential | M.A., CCC-SLP
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Telephone | 843-437-8917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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