Provider Demographics
NPI:1013772896
Name:CORNETT, ASHLEIGH (OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:CORNETT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6849 OAKFORK LOOP
Mailing Address - Street 2:
Mailing Address - City:NEW KENT
Mailing Address - State:VA
Mailing Address - Zip Code:23124-2060
Mailing Address - Country:US
Mailing Address - Phone:804-763-9230
Mailing Address - Fax:
Practice Address - Street 1:250 JOSEPHS DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-3405
Practice Address - Country:US
Practice Address - Phone:757-272-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119009823225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist