Provider Demographics
NPI:1275582199
Name:DODDS, CINDY B (MHSPT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:B
Last Name:DODDS
Suffix:
Gender:F
Credentials:MHSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6261 DONALDSON RD
Mailing Address - Street 2:
Mailing Address - City:MEGGETT
Mailing Address - State:SC
Mailing Address - Zip Code:29449-6184
Mailing Address - Country:US
Mailing Address - Phone:843-478-9575
Mailing Address - Fax:843-889-9160
Practice Address - Street 1:6261 DONALDSON RD
Practice Address - Street 2:
Practice Address - City:MEGGETT
Practice Address - State:SC
Practice Address - Zip Code:29449-6184
Practice Address - Country:US
Practice Address - Phone:843-478-9575
Practice Address - Fax:843-889-9160
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC1300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH0246Medicaid