Provider Demographics
NPI:1265991715
Name:CORBETT, EMILY P (MOT R/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:CORBETT
Suffix:
Gender:F
Credentials:MOT R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1214
Mailing Address - Country:US
Mailing Address - Phone:229-251-1738
Mailing Address - Fax:
Practice Address - Street 1:2704 N OAK ST BLDG A2
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5900
Practice Address - Country:US
Practice Address - Phone:229-253-1009
Practice Address - Fax:229-253-1039
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist