Provider Demographics
NPI:1619317278
Name:BATTLE, PORSCHE' BROWN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PORSCHE'
Middle Name:BROWN
Last Name:BATTLE
Suffix:
Gender:F
Credentials:MA, 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:PO BOX 1791
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-1791
Mailing Address - Country:US
Mailing Address - Phone:843-676-5243
Mailing Address - Fax:
Practice Address - Street 1:3604 FERNANDINA RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5221
Practice Address - Country:US
Practice Address - Phone:843-676-5243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA1435Medicaid