Provider Demographics
NPI:1194570069
Name:ATKINSON, PAULETTE L (MS EDS)
Entity type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:L
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MS EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25630 SW 128TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5733
Mailing Address - Country:US
Mailing Address - Phone:786-270-8665
Mailing Address - Fax:
Practice Address - Street 1:25630 SW 128TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5733
Practice Address - Country:US
Practice Address - Phone:786-270-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist