Individual
DEDRA SHANTAY COX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 WESTLAND PINE CT, COLUMBIA, SC 29229-9517
(803) 394-2228
Mailing address
15 WESTLAND PINE CT, COLUMBIA, SC 29229-9517
(803) 394-2228
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
2018-56113-55006
SC
Other
Enumeration date
06/25/2018
Last updated
09/11/2025
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