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General NPI Number Information
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NPI Number | 1255745386
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Entity Type | Individual
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Provider Name | ADINA ROBERTS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 850 DRESDEN ADAMSVILLE RD
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City | DRESDEN
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State | OH
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Zip | 43821-9703
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Country | US
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Telephone | 760-920-1518
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Fax |
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Provider Business Mailing Address
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Address Line | 850 DRESDEN ADAMSVILLE RD
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City | DRESDEN
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State | OH
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Zip | 43821-9703
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Country | US
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Telephone |
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | OTA2744
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | OTA05336
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | OTA000985
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License Number State | IA
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