Provider Demographics
NPI:1295401024
Name:ADKINS, ELIZABETH AMBURGEY (PH D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:AMBURGEY
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12340 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40337-9619
Mailing Address - Country:US
Mailing Address - Phone:859-585-5891
Mailing Address - Fax:
Practice Address - Street 1:12340 MAIN ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40337-9619
Practice Address - Country:US
Practice Address - Phone:859-585-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty