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NPI Code Detail

MEDICARE: ADRIANA GARDNER

MEDICARE: ADRIANA GARDNER
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
1225X00000XOccupational TherapistOT007037GA

General Provider Information

NPI Number : 1679066088
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIANA GARDNER
Provider Business Mailing Address
First Line : 3179 AMBLEWOOD CT NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-2171
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 DOWNWOOD CIR NW STE 350
Second Line :
City : ATLANTA
State : GA
Zip : 30327-1611
Country : US
Telephone Number : 404-355-2913
Fax Number : 404-351-1684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2018
Last Update Date : 06/11/2018

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Directions to “ ADRIANA GARDNER ” Practice Location

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