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General NPI Number Information
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NPI Number | 1760658660
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Entity Type | Organization
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Legal Business Name | JUST SPEECHY
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 407 CAPERTON WAY
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City | DUNCAN
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State | SC
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Zip | 29334-8966
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Country | US
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Telephone | 864-764-5863
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Fax | 864-486-1686
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Provider Business Mailing Address
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Address Line | 407 CAPERTON WAY
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City | DUNCAN
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State | SC
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Zip | 29334-8966
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Country | US
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Telephone | 864-764-5863
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Fax | 864-486-1686
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/ OWNER
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Name | MRS. LAURA ANN GRAY
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Credential | MED-CCC-SLP
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Telephone | 864-764-5863
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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 | 4018
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License Number State | SC
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