Healthcare Provider Details

I. General information

NPI: 1871763052
Provider Name (Legal Business Name): AIMEE DEVON ADAMS M, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AIMEE DEVON RAY MS, OTR/L

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3728 LIME ROCK RD
EAST BEND NC
27018-7636
US

IV. Provider business mailing address

3728 LIME ROCK RD
EAST BEND NC
27018-7636
US

V. Phone/Fax

Practice location:
  • Phone: 336-699-3899
  • Fax: 336-699-3899
Mailing address:
  • Phone: 336-699-3899
  • Fax: 336-699-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1597
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: