Doctor Name: | KELLY MALONEY |
NPI Number: | 1265808711 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5613 |
Business Practice Address: | 1900 Sunset Blvd West Columbia, SC - 291695959 |
Business Phone Number: | 8022506833 |
Business Fax Number: | 8036930850 |
Mailing Address: | 1900 Sunset Blvd, WEST COLUMBIA |
State: | SC |
Postal Code: | 291695959 |
Phone Number: | 8022506833 |
Fax Number: | 8036930850 |
NPI Enumeration Date: | 08/19/2015 |
NPI Last Update Date: | 08/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5613 |
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 |