Provider Demographics
NPI:1376125229
Name:COUITCHER, CORTNEY (OT)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:COUITCHER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 JACKSON CT
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-7281
Mailing Address - Country:US
Mailing Address - Phone:989-751-0639
Mailing Address - Fax:
Practice Address - Street 1:1171 JACKSON CT
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-7281
Practice Address - Country:US
Practice Address - Phone:989-751-0639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist