Individual
LAUREN GRIGG CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
128 GARNER RD, SPARTANBURG, SC 29303-3149
(864) 591-3484
Mailing address
126 NORTHBROOK ST, BOILING SPRINGS, SC 29316-5133
(864) 381-9023
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6714
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6714
SOUTH CAROLINA OCCUPATIONAL THERAPY LICENSE
SC
Enumeration date
12/21/2022
Last updated
12/21/2022
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