Provider Demographics
NPI:1457691974
Name:EDDINS, VIRGINIA GRIGGS (OT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:GRIGGS
Last Name:EDDINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29709-1534
Mailing Address - Country:US
Mailing Address - Phone:843-921-1030
Mailing Address - Fax:843-921-1036
Practice Address - Street 1:401 WEST BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:SC
Practice Address - Zip Code:29709-1534
Practice Address - Country:US
Practice Address - Phone:843-921-1030
Practice Address - Fax:843-921-1036
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC594225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist