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NPI Code Detail

MEDICARE: LORNA BERNADETTE CORNETT COTA/L

MEDICARE: LORNA BERNADETTE CORNETT COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant4420NC

General Provider Information

NPI Number : 1164682019
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNA BERNADETTE CORNETT COTA/L
Provider Business Mailing Address
First Line : 6 SUGAR MAPLE CT
Second Line :
City : DURHAM
State : NC
Zip : 27703-7172
Country : US
Telephone Number : 919-321-1896
Fax Number :
Provider Business Practice Location Address
First Line : 500 PROSPECT AVE
Second Line :
City : OXFORD
State : NC
Zip : 27565-2543
Country : US
Telephone Number : 919-321-1896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2008
Last Update Date : 06/13/2008

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