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General NPI Number Information
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NPI Number | 1841603370
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Entity Type | Organization
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Legal Business Name | PITTARD SPEECH SERVICES, LLC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 132 TYVOLA DRIVE
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8333
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Country | US
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Telephone | 843-270-7231
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Fax | 843-879-3967
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Provider Business Mailing Address
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Address Line | 132 TYVOLA DRIVE
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8333
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Country | US
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Telephone |
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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 | CAROLINE PITTARD
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Credential | CCC-SLP
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Telephone | 843-270-7231
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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 | 4029
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License Number State | SC
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