Provider Demographics
NPI:1437500899
Name:ADAMS, ANTONIA ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:ELIZABETH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANTONIA
Other - Middle Name:ELIZABETH
Other - Last Name:LOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6091 DEVONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5439
Mailing Address - Country:US
Mailing Address - Phone:678-787-2549
Mailing Address - Fax:
Practice Address - Street 1:2470 DANIELS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6187
Practice Address - Country:US
Practice Address - Phone:706-389-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT0006366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist