Provider Demographics
NPI:1659062388
Name:ATKINS, DEVON ALICIA (MA)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:ALICIA
Last Name:ATKINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 COAL BANK RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:IL
Mailing Address - Zip Code:61548-7878
Mailing Address - Country:US
Mailing Address - Phone:309-643-3924
Mailing Address - Fax:
Practice Address - Street 1:719 W LAKE AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-5941
Practice Address - Country:US
Practice Address - Phone:309-408-1493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health