Provider Demographics
NPI:1992426373
Name:MARSHALL, CORINNE BARNES (OTD)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:BARNES
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 MASON HEADLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2246
Mailing Address - Country:US
Mailing Address - Phone:859-554-8185
Mailing Address - Fax:
Practice Address - Street 1:993 MASON HEADLEY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2246
Practice Address - Country:US
Practice Address - Phone:859-554-8185
Practice Address - Fax:859-554-8186
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY282478225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist