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
| License | State | Type | Specialty |
|---|---|---|---|
| 4377 | SC | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679700348 | Medicaid | SC |
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All providers in Roebuck, SC · Speech-Language Pathologist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.