Provider Demographics
NPI:1861838955
Name:SANDERSON, CATHERINE ANN (MED, MCD-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:MED, 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 1:1001 W SUMTER ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-2205
Mailing Address - Country:US
Mailing Address - Phone:843-679-6898
Mailing Address - Fax:843-673-5795
Practice Address - Street 1:1001 W SUMTER ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-2205
Practice Address - Country:US
Practice Address - Phone:843-679-6898
Practice Address - Fax:843-673-5795
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist