Healthcare Provider Details

I. General information

NPI: 1972427946
Provider Name (Legal Business Name): DELVINA GLADYS JEFFRIES CERTIFIED HAIR LOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 SUNSET BLVD STE 8
WEST COLUMBIA SC
29169-5955
US

IV. Provider business mailing address

635 ROSLINDALE CIR
BLYTHEWOOD SC
29016-9187
US

V. Phone/Fax

Practice location:
  • Phone: 803-882-9372
  • Fax:
Mailing address:
  • Phone: 803-882-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: