Provider Demographics
NPI:1114361599
Name:NEWBERRY COUNTY SCHOOLS
Entity Type:Organization
Organization Name:NEWBERRY COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:SHEALY
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MSP, CCC-SLP
Authorized Official - Phone:803-694-2320
Mailing Address - Street 1:8835 BROAD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POMARIA
Mailing Address - State:SC
Mailing Address - Zip Code:29126-9224
Mailing Address - Country:US
Mailing Address - Phone:803-694-2320
Mailing Address - Fax:
Practice Address - Street 1:2597 HWY 66
Practice Address - Street 2:
Practice Address - City:WHITMIRE
Practice Address - State:SC
Practice Address - Zip Code:29178-9297
Practice Address - Country:US
Practice Address - Phone:803-694-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4704235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty