Provider Demographics
NPI:1902420946
Name:PERKINS ADULT SPEECH SERVICES LLC
Entity Type:Organization
Organization Name:PERKINS ADULT SPEECH SERVICES LLC
Other - Org Name:PERKINS ADULT SPEECH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MSP CCC SLP
Authorized Official - Phone:803-960-4384
Mailing Address - Street 1:106 LINCREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-8101
Mailing Address - Country:US
Mailing Address - Phone:803-960-4384
Mailing Address - Fax:
Practice Address - Street 1:106 LINCREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-8101
Practice Address - Country:US
Practice Address - Phone:803-960-4384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty