Provider Demographics
NPI:1871049643
Name:SPRINGS, MARY CELIA (SLP, CCC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CELIA
Last Name:SPRINGS
Suffix:
Gender:F
Credentials:SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-2814
Mailing Address - Country:US
Mailing Address - Phone:843-777-4075
Mailing Address - Fax:843-777-4066
Practice Address - Street 1:440 2ND LOOP RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-2814
Practice Address - Country:US
Practice Address - Phone:843-777-4075
Practice Address - Fax:843-777-4066
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6089235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist