Southern Oaks Therapy Services LLC
NPI #1710588942 in Fairfax, South Carolina
Provider Information
- NPI Number
- 1710588942
- Entity Type
- Organization
- Organization Name
- Southern Oaks Therapy Services LLC
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Nov 4, 2020
- Last Updated
- Nov 4, 2020
Practice Location
- Address
- 1460 POCOTALIGO RD
- City
- Fairfax
- State
- South Carolina
- ZIP Code
- 29827-6826
- Phone
- (803) 943-6401
Authorized Official
- Name
- KELLY F WALL, MA, CCC-SLP
- Title
- OWNER/SPEECH LANGUAGE PATHOLOGIST
- Phone
- (803) 943-6401
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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