Doctor Name: | AMY WILKES |
NPI Number: | 1922044783 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 3188 |
Business Practice Address: | 9781 Crane Dr Myrtle Beach, SC - 295725530 |
Business Phone Number: | 8434557505 |
Business Fax Number: | |
Mailing Address: | 9781 Crane Dr, MYRTLE BEACH |
State: | SC |
Postal Code: | 295725530 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3188 |
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 |