MEDICARE: SPEECH EXPRESSIONS

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	4273	SC

General Provider Information

NPI Number	:	1821223629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH EXPRESSIONS

Provider Business Mailing Address
First Line	:	352 FRIENDSHIP CHURCH RD
Second Line	:
City	:	NESMITH
State	:	SC
Zip	:	29580-3041
Country	:	US
Telephone Number	:	843-372-6722
Fax Number	:

Provider Business Practice Location Address
First Line	:	352 FRIENDSHIP CHURCH RD
Second Line	:
City	:	NESMITH
State	:	SC
Zip	:	29580-3041
Country	:	US
Telephone Number	:	843-372-6722
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MS. KEYONA MONIQUE NESMITH
Credential	:	M.ED., CCC-SLP
Telephone Number	:	843-372-6722

Provider Enumeration Date	:	05/21/2009
Last Update Date	:	05/21/2009

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Directions to “SPEECH EXPRESSIONS ” Practice Location

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