Provider Demographics
NPI:1326744731
Name:BLANTON, KARSYN
Entity Type:Individual
Prefix:
First Name:KARSYN
Middle Name:
Last Name:BLANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3449
Mailing Address - Country:US
Mailing Address - Phone:803-704-4759
Mailing Address - Fax:803-728-3294
Practice Address - Street 1:113 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3449
Practice Address - Country:US
Practice Address - Phone:803-704-4759
Practice Address - Fax:803-728-3294
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty