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General NPI Number Information
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NPI Number | 1902613714
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Entity Type | Organization
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Legal Business Name | CAROLINA SPEECH WORKS
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1245 ROSEMONT DR STE 115
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City | FORT MILL
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State | SC
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Zip | 29707-7765
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Country | US
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Telephone | 803-281-0185
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 ROSEMONT DR STE 115
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City | FORT MILL
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State | SC
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Zip | 29707-7765
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Country | US
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Telephone | 803-281-0185
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | NICOLE FOURNET KOVERMAN
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Credential | CCC-SLP
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Telephone | 803-984-5156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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