Provider Demographics
NPI:1174247597
Name:RUFUS, KIERA (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KIERA
Middle Name:
Last Name:RUFUS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GATEWAY RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-5400
Mailing Address - Country:US
Mailing Address - Phone:843-796-3964
Mailing Address - Fax:843-796-4326
Practice Address - Street 1:121 GATEWAY RD UNIT B
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-5400
Practice Address - Country:US
Practice Address - Phone:843-796-3964
Practice Address - Fax:843-503-4102
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist