Organization Name: | JAN HAGWOOD COCKE, M.A., CCC-SLP, LLC |
NPI Number: | 1780058578 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAN HAGWOOD COCKE (OWNER) |
Mailing Address: | 3221 Plum Cir Orangeburg |
State: | SC US |
Postal Code: | 291183148 |
Phone Number: | 8033787459 |
Fax Number: | 8035364922 |
NPI Enumeration Date: | 11/17/2015 |
NPI Last Update Date: | 11/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3546 |
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 |