Provider Demographics
NPI:1467927053
Name:HESS, CORIE L (MS)
Entity Type:Individual
Prefix:
First Name:CORIE
Middle Name:L
Last Name:HESS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CORIE
Other - Middle Name:L
Other - Last Name:LOISELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:333 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47305-2465
Mailing Address - Country:US
Mailing Address - Phone:765-286-7000
Mailing Address - Fax:
Practice Address - Street 1:2600 W WHITE RIVER BLVD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-5263
Practice Address - Country:US
Practice Address - Phone:765-286-7000
Practice Address - Fax:765-213-2760
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program