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NPI Code Detail

MEDICARE: KATELYN TALLON CCC-SLP

MEDICARE: KATELYN TALLON CCC-SLP
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 Pathologist7980SC

General Provider Information

NPI Number : 1801570973
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN TALLON CCC-SLP
Provider Business Mailing Address
First Line : 1043 DOCTOR HARDY CIR
Second Line :
City : DILLON
State : SC
Zip : 29536-2774
Country : US
Telephone Number : 843-632-1731
Fax Number :
Provider Business Practice Location Address
First Line : 1990 AUGUSTA ST STE 2500
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-6510
Country : US
Telephone Number : 864-370-0131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2023
Last Update Date : 06/09/2023

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Directions to “ KATELYN TALLON CCC-SLP” Practice Location

Language Start Address Practice Location
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