Provider Demographics
NPI:1184859597
Name:KING, ADRIENNE RENEE (MS, OTR/L)
Entity Type:Individual
Prefix:PROF
First Name:ADRIENNE
Middle Name:RENEE
Last Name:KING
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 DOGWOOD ROAD
Mailing Address - Street 2:SUITE B200 #2232
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-3452
Mailing Address - Country:US
Mailing Address - Phone:770-891-0988
Mailing Address - Fax:
Practice Address - Street 1:850 DOGWOOD ROAD
Practice Address - Street 2:SUITE B200 #2232
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3452
Practice Address - Country:US
Practice Address - Phone:770-891-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004907225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics