Provider Demographics
NPI:1386215747
Name:ADKINS, JANUARY DAWN
Entity Type:Individual
Prefix:
First Name:JANUARY
Middle Name:DAWN
Last Name:ADKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ANTHONI AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6403
Mailing Address - Country:US
Mailing Address - Phone:304-242-6722
Mailing Address - Fax:304-242-6822
Practice Address - Street 1:210 ANTHONI AVE STE 300
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6403
Practice Address - Country:US
Practice Address - Phone:304-242-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician