Provider Demographics
NPI:1417434622
Name:EPPS, TA'TANESE ARAJAI
Entity Type:Individual
Prefix:MS
First Name:TA'TANESE
Middle Name:ARAJAI
Last Name:EPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TATANESE
Other - Middle Name:
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:398 PROMISED LAND RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556
Mailing Address - Country:US
Mailing Address - Phone:843-597-8943
Mailing Address - Fax:915-772-4633
Practice Address - Street 1:1002 STEEPLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8041
Practice Address - Country:US
Practice Address - Phone:803-271-2364
Practice Address - Fax:803-708-5618
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist