Provider Demographics
NPI:1952363731
Name:FEE, ADRIENNE CHARLOTTE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:CHARLOTTE
Last Name:FEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ADRIENNE
Other - Middle Name:CHARLOTTE
Other - Last Name:GAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1251 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3208 BENNER PIKE
Practice Address - Street 2:SUITE 130
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-8475
Practice Address - Country:US
Practice Address - Phone:814-353-9155
Practice Address - Fax:814-353-6111
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01908951Medicaid