Individual
LYDIA MAE CORNEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1434 ROLKIN CT STE 201, CHARLOTTESVILLE, VA 22911-3583
(434) 975-9400
Mailing address
2260 LANFORD HILLS DR, CHARLOTTESVILLE, VA 22911-9100
(434) 242-3345
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119000802
VA
Other
Enumeration date
01/29/2018
Last updated
03/17/2018
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