Provider Demographics
NPI:1205618592
Name:ADAMS, KATINA LYNETTE
Entity type:Individual
Prefix:MS
First Name:KATINA
Middle Name:LYNETTE
Last Name:ADAMS
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 1:6525 WALTERS LANE
Mailing Address - Street 2:202
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747
Mailing Address - Country:US
Mailing Address - Phone:202-413-1832
Mailing Address - Fax:
Practice Address - Street 1:3239 WALTERS LN APT 4
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-3124
Practice Address - Country:US
Practice Address - Phone:202-413-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator