Provider Demographics
NPI:1689188617
Name:GARNER, ADRIENNE DELORIS (OTR)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DELORIS
Last Name:GARNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 NEW KENT HWY
Mailing Address - Street 2:
Mailing Address - City:NEW KENT
Mailing Address - State:VA
Mailing Address - Zip Code:23124-2404
Mailing Address - Country:US
Mailing Address - Phone:804-932-4815
Mailing Address - Fax:
Practice Address - Street 1:8009 NEW KENT HWY
Practice Address - Street 2:
Practice Address - City:NEW KENT
Practice Address - State:VA
Practice Address - Zip Code:23124-2404
Practice Address - Country:US
Practice Address - Phone:804-932-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA011900734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty