Healthcare Provider Details

I. General information

NPI: 1871412056
Provider Name (Legal Business Name): DAPHNE A CHESTER-GARRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11580 WILSON BLVD
RIDGEWAY SC
29130-9403
US

IV. Provider business mailing address

11580 WILSON BLVD
RIDGEWAY SC
29130-9403
US

V. Phone/Fax

Practice location:
  • Phone: 803-463-1685
  • Fax:
Mailing address:
  • Phone: 803-463-1685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: