Provider Demographics
NPI:1619215712
Name:CORBY, KAREN MARIE (OTD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:CORBY
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:AUSTERMILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:4115 MORNING MIST LN
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-6927
Mailing Address - Country:US
Mailing Address - Phone:517-442-6577
Mailing Address - Fax:
Practice Address - Street 1:800 OLD DAWSON VILLAGE RD E STE 10
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-3818
Practice Address - Country:US
Practice Address - Phone:770-676-1971
Practice Address - Fax:678-807-2537
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006995225X00000X
MI5201008317225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist