Provider Demographics
NPI:1073212452
Name:ATKINS, EMILY (COTA/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GRASSLAND RD
Mailing Address - Street 2:
Mailing Address - City:CAMPOBELLO
Mailing Address - State:SC
Mailing Address - Zip Code:29322-9707
Mailing Address - Country:US
Mailing Address - Phone:864-580-8871
Mailing Address - Fax:
Practice Address - Street 1:319 GARLINGTON RD STE B5
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4621
Practice Address - Country:US
Practice Address - Phone:864-417-8423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5511224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant