Provider Demographics
NPI:1356863674
Name:COOK, STEPHANIE CORBITT (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CORBITT
Last Name:COOK
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 UNIVERSITY PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5485
Mailing Address - Country:US
Mailing Address - Phone:850-208-6120
Mailing Address - Fax:850-208-6129
Practice Address - Street 1:9400 UNIVERSITY PKWY STE 104
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5485
Practice Address - Country:US
Practice Address - Phone:850-208-6120
Practice Address - Fax:850-208-6129
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8728225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand