Provider Demographics
NPI:1619167343
Name:FARMER, RITA ROBERTS (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:ROBERTS
Last Name:FARMER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ANN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:138 PINE LAKE RNCH
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-8865
Mailing Address - Country:US
Mailing Address - Phone:304-563-9893
Mailing Address - Fax:
Practice Address - Street 1:698 HOWARD STREET
Practice Address - Street 2:SPARTANBURG SCHOOL DISTRICT 7
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-9612
Practice Address - Country:US
Practice Address - Phone:864-596-8423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0460235Z00000X
SC5121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist