Provider Demographics
NPI:1053631598
Name:WHITE, BRANDY HULSEY (MCD CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:HULSEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:MCD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-8531
Mailing Address - Country:US
Mailing Address - Phone:843-383-2687
Mailing Address - Fax:
Practice Address - Street 1:313 W CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4521
Practice Address - Country:US
Practice Address - Phone:843-332-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist