Provider Demographics
NPI:1275827610
Name:ARISTILDE, WANDIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:WANDIE
Middle Name:
Last Name:ARISTILDE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6340 PLATT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-8304
Mailing Address - Country:US
Mailing Address - Phone:803-821-5100
Mailing Address - Fax:
Practice Address - Street 1:6340 PLATT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8304
Practice Address - Country:US
Practice Address - Phone:803-821-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist