Provider Demographics
NPI:1972705523
Name:ATKINS, ADRIA (OT)
Entity Type:Individual
Prefix:
First Name:ADRIA
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 VICTORY PALM DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-4410
Mailing Address - Country:US
Mailing Address - Phone:347-755-3839
Mailing Address - Fax:
Practice Address - Street 1:2214 VICTORY PALM DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-4410
Practice Address - Country:US
Practice Address - Phone:347-755-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist