Provider Demographics
NPI:1295007474
Name:NOTEABLE PATHWAYS THERAPEUTICS LLC
Entity Type:Organization
Organization Name:NOTEABLE PATHWAYS THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WYGELIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:803-972-1945
Mailing Address - Street 1:PO BOX 1854
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:340 RAST ST
Practice Address - Street 2:STE 2
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2595
Practice Address - Country:US
Practice Address - Phone:803-972-1945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty