Provider Demographics
NPI:1295995413
Name:CORCORAN, TRICIA LYNN (LAC, DIPL OM)
Entity type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:LYNN
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:11422 S LAKE RUN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-8716
Mailing Address - Country:US
Mailing Address - Phone:415-987-8147
Mailing Address - Fax:888-972-4948
Practice Address - Street 1:10382 S JORDAN GTWY STE 150
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4190
Practice Address - Country:US
Practice Address - Phone:415-987-8147
Practice Address - Fax:888-972-4948
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT11940180-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist