Provider Demographics
NPI:1679580153
Name:HARVIN, ELIZABETH S (MCD/CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:S
Last Name:HARVIN
Suffix:
Gender:F
Credentials:MCD/CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4263 LIVE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8484
Mailing Address - Country:US
Mailing Address - Phone:843-661-0649
Mailing Address - Fax:
Practice Address - Street 1:875 WOOD DUCK LN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3919
Practice Address - Country:US
Practice Address - Phone:843-661-2109
Practice Address - Fax:843-661-2109
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3994OtherSTATE LICENSE