Doctor Name: | MS. MANDY STEVENS |
NPI Number: | 1073944864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, SLP |
License Number: | 250607 |
Business Practice Address: | 2050 Pine Log Rd Aiken, SC - 298035731 |
Business Phone Number: | 8036412740 |
Business Fax Number: | |
Mailing Address: | 120 Alpine Dr, AIKEN |
State: | SC |
Postal Code: | 298039712 |
Phone Number: | 9042481167 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2013 |
NPI Last Update Date: | 12/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 250607 |
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 |