Katherine Vickery, MS, CCC/SLP

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

NPI 1992333561 · NPPES record last updated Mar 30, 2020

Key facts

NPI
1992333561
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2157 (SC)
Practice address
325 Motlow School Rd
Campobello, SC 29322-9675
Phone
(864) 472-8120
NPI assigned
Mar 30, 2020
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
2157SCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2157 SC Yes

Addresses

Primary practice location

325 Motlow School Rd
Campobello, SC 29322-9675

Mailing address

302 Cherry Hill Rd
Greenville, SC 29607-5412
Phone (864) 979-0894

Other providers in Campobello, SC

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

Sources for this page

Verify at the official NPI Registry.