Basic Information
| Provider Information | |||||||||
| NPI: | 1942918743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | ANDREONA | ||||||||
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| Credential: | M.A., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3026 N OLD RIVER RD | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295054201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436106368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1002 STEEPLE RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | IRMO | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290638041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032712364 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2022 | ||||||||
| LastUpdateDate: | 11/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 5404 | SC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.