Doctor Name: | MRS. GENEA DESHIELDS DESHIELDS BOYKIN |
NPI Number: | 1013193820 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSP CCC SLP |
License Number: | 3951 |
Business Practice Address: | 355 Ridge Run Trail Irmo, SC - 29063 |
Business Phone Number: | 8032712364 |
Business Fax Number: | 8037085618 |
Mailing Address: | 355 Ridge Run Trail, IRMO |
State: | SC |
Postal Code: | 29063 |
Phone Number: | 8032712364 |
Fax Number: | 8037085618 |
NPI Enumeration Date: | 01/11/2008 |
NPI Last Update Date: | 01/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |