Individual
GARRETT MICHAEL CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
627 CUPPS BRIDGE RD, FRANKFORT, OH 45628-9586
(740) 649-8785
Mailing address
627 CUPPS BRIDGE RD, FRANKFORT, OH 45628-9586
(740) 649-8785
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
454920
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
454920
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
—
Enumeration date
11/20/2021
Last updated
11/20/2021
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