| Organization Name: | PALMETTO SPEECH & LANGUAGE ASSOC, LLC |
| NPI Number: | 1184870206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GENA C RANDOLPH (OWNER) |
| Mailing Address: | 3185 Azalea Drive North Charleston |
| State: | SC US |
| Postal Code: | 29405 |
| Phone Number: | 8433889990 |
| Fax Number: | 8433880349 |
| NPI Enumeration Date: | 08/08/2008 |
| NPI Last Update Date: | 08/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3120 |
| 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 |