Provider Demographics
NPI:1164916359
Name:VINETTE, GUY JOSEPH II (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:JOSEPH
Last Name:VINETTE
Suffix:II
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 1:318 SAUCER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-0901
Mailing Address - Country:US
Mailing Address - Phone:716-550-0083
Mailing Address - Fax:
Practice Address - Street 1:318 SAUCER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-0901
Practice Address - Country:US
Practice Address - Phone:716-550-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist