Provider Demographics
NPI:1992043723
Name:EDDINGTON, SANDRA (MSW X-07998)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:EDDINGTON
Suffix:
Gender:F
Credentials:MSW X-07998
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 BALDWIN ROWE CIR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-5894
Mailing Address - Country:US
Mailing Address - Phone:907-947-0270
Mailing Address - Fax:
Practice Address - Street 1:2605 THOMAS DR STE 210
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-6219
Practice Address - Country:US
Practice Address - Phone:907-947-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-07998101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor