Provider Demographics
NPI:1295976561
Name:WEBB, PATRICIA W (CCC-SLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:W
Last Name:WEBB
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:DYAN
Other - Middle Name:WEST
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC/SLP
Mailing Address - Street 1:722 FAIRWAY LAKES RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-8437
Mailing Address - Country:US
Mailing Address - Phone:864-229-3114
Mailing Address - Fax:864-229-3114
Practice Address - Street 1:722 FAIRWAY LAKES RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-8437
Practice Address - Country:US
Practice Address - Phone:864-229-3114
Practice Address - Fax:864-229-3114
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2127235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist