Provider Demographics
NPI:1790823656
Name:BRAND, MONICA S (CCC,SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:S
Last Name:BRAND
Suffix:
Gender:F
Credentials:CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CASHUA FERRY RD
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-8488
Mailing Address - Country:US
Mailing Address - Phone:843-777-2250
Mailing Address - Fax:843-777-2051
Practice Address - Street 1:701 CASHUA FERRY RD
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-8488
Practice Address - Country:US
Practice Address - Phone:843-777-2250
Practice Address - Fax:843-777-2051
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGPO334Medicaid
SCGPO334Medicaid