Provider Demographics
NPI:1174762710
Name:ADAMS, KIMBERLEY ANN (COTA)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLEY
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NEESE DR APT G30
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2773
Mailing Address - Country:US
Mailing Address - Phone:615-331-5120
Mailing Address - Fax:
Practice Address - Street 1:141 NEESE DR APT G30
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2773
Practice Address - Country:US
Practice Address - Phone:615-331-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA164224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant