Provider Demographics
NPI:1770033961
Name:ATKINS, KATIE DELAUNE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:DELAUNE
Last Name:ATKINS
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 1:138 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1404
Mailing Address - Country:US
Mailing Address - Phone:864-534-3642
Mailing Address - Fax:
Practice Address - Street 1:138 OAKLAND DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1404
Practice Address - Country:US
Practice Address - Phone:864-534-3642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4893225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist