Provider Demographics
NPI:1598570616
Name:MEADE, VICTORIA ASHLEY (OTR/L)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:MEADE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 NEWTON RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2948
Mailing Address - Country:US
Mailing Address - Phone:304-928-9599
Mailing Address - Fax:
Practice Address - Street 1:544 NEWTON RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2948
Practice Address - Country:US
Practice Address - Phone:304-928-9599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist