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General NPI Number Information
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NPI Number | 1760367825
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Entity Type | Individual
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Provider Name | CORIE SUE MAHAN
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | SONNENBERGER STR. 64
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City | WIESBADEN
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State | HESSEN
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Zip | 65187
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Country | DE
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Telephone | 572-290-9839
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Fax |
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Provider Business Mailing Address
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Address Line | AM MELONENBERG 8
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City | WIESBADEN
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State | HESSEN
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Zip | 65187
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Country | DE
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-82277
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License Number State |
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