Provider Demographics
NPI:1659083582
Name:LACORTE, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:LACORTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ROBINDALE ST
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1839
Mailing Address - Country:US
Mailing Address - Phone:440-278-0279
Mailing Address - Fax:
Practice Address - Street 1:2000 AUBURN DR STE 200
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4328
Practice Address - Country:US
Practice Address - Phone:440-278-0279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist