Provider Demographics
NPI:1548705866
Name:FORGETTE, CORTNEY ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:ANN
Last Name:FORGETTE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 S WHITEVILLE RD
Mailing Address - Street 2:CENTRAL MICHIGAN CARE
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858
Mailing Address - Country:US
Mailing Address - Phone:989-854-8334
Mailing Address - Fax:
Practice Address - Street 1:798 S WHITEVILLE RD
Practice Address - Street 2:CENTRAL MICHIGAN CARE
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-854-8334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8271-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
106S00000XMedicare Oscar/Certification