Leiloni N Nix, M.S.,SLP

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

NPI 1679700348 · NPPES record last updated Aug 4, 2009

Key facts

NPI
1679700348
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
4377 (SC)
Practice address
441 Lancaster Farm Rd
Roebuck, SC 29376-3727
Phone
(888) 230-2022
Fax
(888) 483-7046
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4377SCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4377 SC Yes

Addresses

Primary practice location

441 Lancaster Farm Rd
Roebuck, SC 29376-3727

Mailing address

441 Lancaster Farm Rd
Roebuck, SC 29376-3727
Phone (888) 230-2022

Other identifiers

IdentifierTypeStateIssuer
1679700348MedicaidSC

Other providers in Roebuck, SC

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

Sources for this page

Verify at the official NPI Registry.