Provider Demographics
NPI:1467920991
Name:BURDETTE, CHARITY HAWKINS (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:HAWKINS
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:MISS
Other - First Name:CHARITY
Other - Middle Name:ALAINA
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSP, CCC-SLP
Mailing Address - Street 1:1136 WRIGHT SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-8317
Mailing Address - Country:US
Mailing Address - Phone:864-296-1776
Mailing Address - Fax:
Practice Address - Street 1:1136 WRIGHT SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-8317
Practice Address - Country:US
Practice Address - Phone:864-296-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist