Mutcherson, Desiree D
Mutcherson, Desiree D is an individual health care provider with primary practice located at 200 Keats Dr 221, Spartanburg SC 29301-4956. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mutcherson, Desiree D can be contacted via phone (813) 545-3042.Contact Information
Primary practice address
200 Keats Dr 221
Spartanburg SC 29301-4956
Phone: (813) 545-3042
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA5247 | Florida |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 5292 | South Carolina |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SP-1568 | Hawaii |
Profile Details
| NPI number | 1962504662 |
|---|---|
| LBN Legal business name | Mutcherson, Desiree D |
| Credentials | MS,CCC/SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2006 |
| Last updated | Aug 2nd, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962504662 | NPPES |
| Florida | MEDICAID | 681570796 | |
| Florida | MEDICAID | 888523100 |
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