Healthcare Provider Details

I. General information

NPI: 1326287301
Provider Name (Legal Business Name): CORA LYNN JARBOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 E GREENVILLE ST STE A
ANDERSON SC
29621-2285
US

IV. Provider business mailing address

113 DUGOUT COVE RD
ANDERSON SC
29626-6469
US

V. Phone/Fax

Practice location:
  • Phone: 864-870-1360
  • Fax: 864-870-1363
Mailing address:
  • Phone: 828-582-1712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8939
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA10561
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: