Provider Demographics
NPI:1629035498
Name:ADAMS, DANA M (MSR, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MSR, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTBURY RD
Mailing Address - Street 2:
Mailing Address - City:ST. GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-7126
Mailing Address - Country:US
Mailing Address - Phone:843-509-4115
Mailing Address - Fax:
Practice Address - Street 1:200 WESTBURY RD
Practice Address - Street 2:
Practice Address - City:ST. GEORGE
Practice Address - State:SC
Practice Address - Zip Code:29477-7126
Practice Address - Country:US
Practice Address - Phone:843-509-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist