Provider Demographics
NPI:1447713961
Name:CARTER, SYDNEY TAYLOR (MS)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:TAYLOR
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WOODPOND CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1704
Mailing Address - Country:US
Mailing Address - Phone:501-539-3707
Mailing Address - Fax:
Practice Address - Street 1:2113 ADAMS GRV STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6957
Practice Address - Country:US
Practice Address - Phone:803-767-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist