Provider Demographics
NPI:1679191209
Name:ENGLISH, ADRIAN JACQUECE
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:JACQUECE
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741233
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1319
Mailing Address - Country:US
Mailing Address - Phone:706-588-5452
Mailing Address - Fax:
Practice Address - Street 1:342 NELSON ST SW UNIT 220
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-1341
Practice Address - Country:US
Practice Address - Phone:706-588-5452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator