Provider Demographics
NPI:1326818600
Name:CORIA, YANET (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:CORIA
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:YANET
Other - Middle Name:
Other - Last Name:CORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:YANET CORIA MSW, LSW
Mailing Address - Street 1:112 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-2122
Mailing Address - Country:US
Mailing Address - Phone:574-303-5338
Mailing Address - Fax:
Practice Address - Street 1:401 W BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-3019
Practice Address - Country:US
Practice Address - Phone:574-400-7685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33011898A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty