Healthcare Provider Details

I. General information

NPI: 1962459586
Provider Name (Legal Business Name): AIMEE KINNIKIN ADAMS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 CONTINENTAL DR
RENO NV
89509-3431
US

IV. Provider business mailing address

1865 BONNEVILLE AVE
RENO NV
89503-2411
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-3300
  • Fax: 775-324-3382
Mailing address:
  • Phone: 775-787-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4216-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: