Katie Ledford Rodriguez

Individual provider Active NPI Speech-Language Pathologist · Edgemoor, SC

NPI 1083395396 · NPPES record last updated Jul 28, 2023

Key facts

NPI
1083395396
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7405 (SC)
Practice address
507 Patriot LN
Edgemoor, SC 29712-8704
Phone
(803) 367-6109
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7405SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Speech and Swallowing Therapy, LLC Speech-Language Pathologist Past
since Jul 31, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7405 SC Yes

Addresses

Primary practice location

507 Patriot LN
Edgemoor, SC 29712-8704

Mailing address

3310 Brushy Mountain St
Cary, NC 27519-7234
Phone (803) 493-7917

Other providers in Edgemoor, SC

All providers in Edgemoor, SC · Speech-Language Pathologist in South Carolina

Sources for this page

Verify at the official NPI Registry.