Provider Demographics
NPI:1376980771
Name:ADAMS, ROBBIE KAY (COTA/L)
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:KAY
Last Name:ADAMS
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 1:3140 BROOKER CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1505
Mailing Address - Country:US
Mailing Address - Phone:231-250-0805
Mailing Address - Fax:
Practice Address - Street 1:3140 BROOKER CREEK WAY
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-1505
Practice Address - Country:US
Practice Address - Phone:231-250-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12467224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant