Provider Demographics
NPI:1700020336
Name:CORNELL-SHERIFF, JAMIE ELIZABETH (OT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:CORNELL-SHERIFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ELIZABETH
Other - Last Name:CORNELL- SHERIFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4310 LONDONDERRY RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5300
Mailing Address - Country:US
Mailing Address - Phone:717-657-7520
Mailing Address - Fax:
Practice Address - Street 1:4310 LONDONDERRY RD
Practice Address - Street 2:BLOOM BLDG
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5300
Practice Address - Country:US
Practice Address - Phone:717-657-7520
Practice Address - Fax:717-657-7505
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009267225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist