Provider Demographics
NPI:1174291074
Name:MCCORMICK, KARI LAUREN I (COTA/L)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LAUREN
Last Name:MCCORMICK
Suffix:I
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:KARI
Other - Middle Name:LAUREN
Other - Last Name:MCCORMICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:254 HURON ST
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-1911
Mailing Address - Country:US
Mailing Address - Phone:330-715-5513
Mailing Address - Fax:
Practice Address - Street 1:703 S MAIN ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1098
Practice Address - Country:US
Practice Address - Phone:330-715-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007985224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant