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General NPI Number Information
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NPI Number | 1962869883
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Entity Type | Organization
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Legal Business Name | EFFECTIVE EXPRESSION L.L.C.
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 2113 ADAMS GRV
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City | COLUMBIA
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State | SC
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Zip | 29203-6951
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Country | US
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Telephone | 803-707-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 4305 WILLINGHAM DR
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City | COLUMBIA
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State | SC
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Zip | 29206-1448
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Country | US
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Telephone | 803-707-6248
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | JULIA WOOTEN PRINCIPE
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Credential | MSP, CCC-SLP
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Telephone | 803-707-6248
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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 | 4738
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License Number State | SC
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