MEDICARE: CAROLINA CADENCE SPEECH THERAPY LLC

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1376309732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA CADENCE SPEECH THERAPY LLC

Provider Business Mailing Address
First Line	:	2203 MARION ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-1917
Country	:	US
Telephone Number	:	843-593-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	2203 MARION ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-1917
Country	:	US
Telephone Number	:	843-593-7625
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CORY R DAUBER
Credential	:	M.S. CCC-SLP
Telephone Number	:	843-593-7625

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	02/23/2024

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Directions to “CAROLINA CADENCE SPEECH THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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