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General NPI Number Information
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NPI Number | 1194176461
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Entity Type | Individual
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Provider Name | ANTONIA ADAMS
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 410 SHERRON AVE
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City | BAKER
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State | LA
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Zip | 70714-4144
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Country | US
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Telephone | 225-276-0637
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Fax |
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Provider Business Mailing Address
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Address Line | 6468 LAKERIDGE DR
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City | ZACHARY
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State | LA
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Zip | 70791-7459
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Country | US
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Telephone | 225-480-7760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 7407
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PLPC7407
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License Number State | LA
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