Provider Demographics
NPI:1679314975
Name:ATKINS, DEIJAH RENEE
Entity type:Individual
Prefix:
First Name:DEIJAH
Middle Name:RENEE
Last Name:ATKINS
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 1:3112 WATERFORD CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-4417
Mailing Address - Country:US
Mailing Address - Phone:310-871-1215
Mailing Address - Fax:
Practice Address - Street 1:3112 WATERFORD CLUB DR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-4417
Practice Address - Country:US
Practice Address - Phone:310-871-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician