Provider Demographics
NPI:1942611215
Name:SLP SERVICES, LLC
Entity Type:Organization
Organization Name:SLP SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE/PATHOLOGST
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA;CCC/SLP
Authorized Official - Phone:803-747-7301
Mailing Address - Street 1:2379 MALL TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2986
Mailing Address - Country:US
Mailing Address - Phone:803-747-7013
Mailing Address - Fax:
Practice Address - Street 1:2379 MALL TERRACE CT
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2986
Practice Address - Country:US
Practice Address - Phone:803-747-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1034235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty