Individual
MRS. JANINE ELISE CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4201 LAKE BOONE TRL, STE 4, RALEIGH, NC 27607-7512
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRL, STE 4, RALEIGH, NC 27607-7512
(919) 781-4434
(919) 781-5851
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2508
NC
225XP0200X
Pediatric Occupational Therapist
Primary
2508
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036V
BLUE CROSS BLUE SHILD OF
NC
05
—
7311133
—
NC
Enumeration date
08/19/2006
Last updated
10/10/2008
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