Provider Demographics
NPI:1164631636
Name:MCZEKE, WARRICK JOVAN (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:WARRICK
Middle Name:JOVAN
Last Name:MCZEKE
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 TELFAIR WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2381
Mailing Address - Country:US
Mailing Address - Phone:843-283-8974
Mailing Address - Fax:
Practice Address - Street 1:1537 TELFAIR WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2381
Practice Address - Country:US
Practice Address - Phone:843-817-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist