Provider Demographics
NPI:1356660625
Name:TENCE CORBIN, LUCY ARAUJO (AUD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:ARAUJO
Last Name:TENCE CORBIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 LINE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-1677
Mailing Address - Country:US
Mailing Address - Phone:570-245-1526
Mailing Address - Fax:570-245-0028
Practice Address - Street 1:1214 LINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1677
Practice Address - Country:US
Practice Address - Phone:570-245-1526
Practice Address - Fax:570-245-0028
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006116231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025374300001Medicaid
196271QP8OtherMEDICARE PTAN