Provider Demographics
NPI:1598227092
Name:CORNELL, ERIN NICOLE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:CORNELL
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 SHENLEY DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4629
Mailing Address - Country:US
Mailing Address - Phone:203-837-6304
Mailing Address - Fax:
Practice Address - Street 1:611 SHENLEY DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4629
Practice Address - Country:US
Practice Address - Phone:203-837-6304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics