Provider Demographics
NPI:1962665307
Name:PALMETTO SPEECH LANGUAGE LITERACY GROUP, LLC
Entity Type:Organization
Organization Name:PALMETTO SPEECH LANGUAGE LITERACY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:803-750-3586
Mailing Address - Street 1:1013 BROAD RIVER RD
Mailing Address - Street 2:STE 211
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-3649
Mailing Address - Country:US
Mailing Address - Phone:803-750-3586
Mailing Address - Fax:
Practice Address - Street 1:1013 BROAD RIVER RD
Practice Address - Street 2:STE 211
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-3649
Practice Address - Country:US
Practice Address - Phone:803-750-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3474235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty