MEDICARE: KAREN MARIE CORBY OTD

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
1	225X00000X	Occupational Therapist	OT006995	GA
2	225X00000X	Occupational Therapist	5201008317	MI

General Provider Information

NPI Number	:	1619215712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MARIE CORBY OTD

Provider Business Mailing Address
First Line	:	4115 MORNING MIST LN
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30028-6927
Country	:	US
Telephone Number	:	517-442-6577
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 OLD DAWSON VILLAGE RD E STE 10
Second Line	:
City	:	DAWSONVILLE
State	:	GA
Zip	:	30534-3818
Country	:	US
Telephone Number	:	770-676-1971
Fax Number	:	678-807-2537

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2013
Last Update Date	:	04/13/2021

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Directions to “ KAREN MARIE CORBY OTD” Practice Location

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