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NPI Code Detail

MEDICARE: ELIZABETH ANN GAGE

MEDICARE: ELIZABETH ANN GAGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1174804967
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN GAGE
Provider Business Mailing Address
First Line : PO BOX 1753
Second Line :
City : MT PLEASANT
State : SC
Zip : 29465-1753
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1127 QUEENSBOROUGH BLVD STE 104
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-5431
Country : US
Telephone Number : 843-216-0290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2011
Last Update Date : 02/11/2020

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Directions to “ ELIZABETH ANN GAGE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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