Provider Demographics
NPI:1346916178
Name:ATKINS, GRACE D (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:D
Last Name:ATKINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:D
Other - Last Name:CASTRONOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7730 AVERY LN
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-8345
Mailing Address - Country:US
Mailing Address - Phone:251-391-9087
Mailing Address - Fax:251-342-2060
Practice Address - Street 1:7730 AVERY LN
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-8345
Practice Address - Country:US
Practice Address - Phone:251-391-9087
Practice Address - Fax:251-342-2060
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2024-02-16
Deactivation Date:2021-08-20
Deactivation Code:
Reactivation Date:2022-07-13
Provider Licenses
StateLicense IDTaxonomies
AL4009225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist