Provider Demographics
NPI:1306185111
Name:POWELL, RILEY SLOAN (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RILEY
Middle Name:SLOAN
Last Name:POWELL
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 1:1014 CARLISLE PL
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3684
Mailing Address - Country:US
Mailing Address - Phone:864-276-2220
Mailing Address - Fax:
Practice Address - Street 1:1700 S FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29624-3321
Practice Address - Country:US
Practice Address - Phone:864-260-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist