Provider Demographics
NPI:1790027696
Name:ADAMS, JEANINE MILLER (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:MILLER
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JEANINE
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7536 GARDNER PARK DR STE 7536
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3414
Mailing Address - Country:US
Mailing Address - Phone:703-754-4770
Mailing Address - Fax:703-754-4435
Practice Address - Street 1:7536 GARDNER PARK DR STE 7536
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3414
Practice Address - Country:US
Practice Address - Phone:703-754-4770
Practice Address - Fax:703-754-4435
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005903225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand