Provider Demographics
NPI:1326287301
Name:JARBOE, CORA
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:
Last Name:JARBOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 E US 64 ALT STE D
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-4752
Mailing Address - Country:US
Mailing Address - Phone:828-516-1750
Mailing Address - Fax:828-516-1749
Practice Address - Street 1:4400 E US 64 ALT STE D
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-4752
Practice Address - Country:US
Practice Address - Phone:828-516-1750
Practice Address - Fax:828-516-1749
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
NC15138235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002001400Medicaid
FL000877700Medicaid
FLFE911ZMedicare PIN