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NPI Code Detail

MEDICARE: DENISE M BROMER SLP

MEDICARE: DENISE M BROMER 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 Pathologist4296SC
2235Z00000XSpeech-Language Pathologist351565294SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14296OTHERSCLICENSE #

General Provider Information

NPI Number : 1962783688
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE M BROMER SLP
Provider Business Mailing Address
First Line : 3100 TRADITION CIR
Second Line :
City : MT PLEASANT
State : SC
Zip : 29466-7200
Country : US
Telephone Number : 843-654-7945
Fax Number : 843-884-6481
Provider Business Practice Location Address
First Line : 3100 TRADITION CIR
Second Line :
City : MT PLEASANT
State : SC
Zip : 29466-7200
Country : US
Telephone Number : 843-654-7945
Fax Number : 843-884-6481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 09/08/2011

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Directions to “ DENISE M BROMER SLP” Practice Location

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