Individual
SUSAN R CORNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1700 FALLEN LEAF LN, ROUND ROCK, TX 78665-5657
(512) 788-0048
Mailing address
1700 FALLEN LEAF LN, ROUND ROCK, TX 78665-5657
(512) 788-0048
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216020
TX
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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