Provider Demographics
NPI:1477897957
Name:ADAMS, ERIN RAE (COTA/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RAE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:RAE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1500 PRIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-9157
Mailing Address - Country:US
Mailing Address - Phone:270-821-1813
Mailing Address - Fax:
Practice Address - Street 1:1500 PRIDE AVE
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9157
Practice Address - Country:US
Practice Address - Phone:270-821-1813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA3237224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant