Provider Demographics
NPI:1073288502
Name:ADAMS, ABIGAIL (COTA/L)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:18459 HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:STEELVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65565-6020
Mailing Address - Country:US
Mailing Address - Phone:573-201-4960
Mailing Address - Fax:
Practice Address - Street 1:18459 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:STEELVILLE
Practice Address - State:MO
Practice Address - Zip Code:65565-6020
Practice Address - Country:US
Practice Address - Phone:573-201-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021017791224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant