Provider Demographics
NPI:1548661689
Name:MEEKS, CHRISTINA (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 BELFORD GROVE DR APT 302
Mailing Address - Street 2:AIKEN
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-1073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 DOUBLE SPRINGS RD
Practice Address - Street 2:AIKEN
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-8174
Practice Address - Country:US
Practice Address - Phone:803-827-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN265054103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool