Provider Demographics
NPI:1427303734
Name:MCMILLAN, ADRIENNE BARRON (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:BARRON
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2403
Mailing Address - Country:US
Mailing Address - Phone:803-395-2600
Mailing Address - Fax:803-395-2594
Practice Address - Street 1:1895 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2403
Practice Address - Country:US
Practice Address - Phone:803-395-2600
Practice Address - Fax:803-395-2594
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1082225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation