Healthcare Provider Details

I. General information

NPI: 1780332759
Provider Name (Legal Business Name): CORRIN JENNIFER CORBIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 WEST ST STE 218
PITTSBURGH PA
15221-2838
US

IV. Provider business mailing address

250 JEFFERSON DR APT 306
MC KEES ROCKS PA
15136-3713
US

V. Phone/Fax

Practice location:
  • Phone: 412-407-3332
  • Fax: 412-612-2618
Mailing address:
  • Phone: 412-600-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: