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Individual

MRS. ERICA CORNELISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
350 E TICKLE ST, DYERSBURG, TN 38024-3118
(731) 285-9710
Mailing address
4040 BEECH BLUFF RD, BEECH BLUFF, TN 38313-9364

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0000005020
TN

Other

Enumeration date
01/07/2016
Last updated
01/07/2016
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