MEDICARE: ADRIENNE NICOLE TOLSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT210002050	DC
2	225X00000X	Occupational Therapist	08405	MD

General Provider Information

NPI Number	:	1447880406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE NICOLE TOLSON

Provider Business Mailing Address
First Line	:	12158 CENTRAL AVE
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721
Country	:	US
Telephone Number	:	301-390-3076
Fax Number	:

Provider Business Practice Location Address
First Line	:	12158 CENTRAL AVE
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-1932
Country	:	US
Telephone Number	:	301-430-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2020
Last Update Date	:	01/20/2026

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Directions to “ ADRIENNE NICOLE TOLSON ” Practice Location

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