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General NPI Number Information
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NPI Number | 1336343029
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Entity Type | Individual
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Provider Name | ADRIANE LYNN CORLEW
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 416 CONNABLE AVE
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City | PETOSKEY
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State | MI
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Zip | 49770-2212
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Country | US
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Telephone | 231-487-3614
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Fax | 231-487-7791
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Provider Business Mailing Address
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Address Line | 6923 HUGHSTON RD
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City | HARBOR SPRINGS
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State | MI
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Zip | 49740-9356
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Country | US
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Telephone | 810-588-3573
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201007124
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License Number State | MI
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