Provider Demographics
NPI:1467885798
Name:FINN, KORYE (BCABA)
Entity Type:Individual
Prefix:
First Name:KORYE
Middle Name:
Last Name:FINN
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6167 BRISTOL PKWY
Mailing Address - Street 2:130
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6610
Mailing Address - Country:US
Mailing Address - Phone:310-410-4450
Mailing Address - Fax:310-410-4455
Practice Address - Street 1:6167 BRISTOL PKWY
Practice Address - Street 2:130
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6610
Practice Address - Country:US
Practice Address - Phone:310-410-4450
Practice Address - Fax:310-410-4455
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-05-1743103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst