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General NPI Number Information
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NPI Number | 1871541888
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Entity Type | Individual
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Provider Name | TARA CRAIG ADAMS MCD, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 355 OAK GROVE RD
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City | SPARTANBURG
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State | SC
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Zip | 29301-2537
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Country | US
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Telephone | 864-595-4225
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Fax |
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Provider Business Mailing Address
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Address Line | 629 BRANCH VIEW DR
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City | BOILING SPRINGS
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State | SC
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Zip | 29316-4836
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Country | US
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Telephone | 870-674-4061
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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 | SP#2069
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP.4636 SLP
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License Number State | SC
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