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General NPI Number Information
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NPI Number | 1548884620
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Entity Type | Individual
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Provider Name | MS. LATARA MONIQUE ARMSTRONG
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Gender | Female
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 1 MARTHA FRANKS DR
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City | LAURENS
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State | SC
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Zip | 29360-1772
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Country | US
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Telephone | 864-984-4541
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Fax |
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Provider Business Mailing Address
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Address Line | 535 BROOKWOOD POINT PL APT 312
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-6931
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Country | US
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Telephone | 803-556-5041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SLP.7202SPIN
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License Number State | SC
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