Basic Information
| Provider Information | |||||||||
| NPI: | 1467008144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADKINS | ||||||||
| FirstName: | CLIFTON | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7665 KRISTIN DR | ||||||||
| Address2: | |||||||||
| City: | PENN LAIRD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228469514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402148763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1150 NORTHWEST DR | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229012309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349737933 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2019 | ||||||||
| LastUpdateDate: | 08/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 0131001081 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.