Provider Demographics
NPI:1871344358
Name:CORBIN, ADIA (PARAPROFESSIONAL)
Entity type:Individual
Prefix:
First Name:ADIA
Middle Name:
Last Name:CORBIN
Suffix:
Gender:F
Credentials:PARAPROFESSIONAL
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:CORBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:701 BENONI AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-2508
Mailing Address - Country:US
Mailing Address - Phone:681-404-6135
Mailing Address - Fax:
Practice Address - Street 1:701 BENONI AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2508
Practice Address - Country:US
Practice Address - Phone:681-404-6135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant