Provider Demographics
NPI:1477580256
Name:COREY, CARRIE BETH (LAC, ATC, CMT)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:BETH
Last Name:COREY
Suffix:
Gender:F
Credentials:LAC, ATC, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-4640
Mailing Address - Country:US
Mailing Address - Phone:240-432-4949
Mailing Address - Fax:
Practice Address - Street 1:7303 RIVER RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-4640
Practice Address - Country:US
Practice Address - Phone:240-432-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM03636225700000X
MDU01552171100000X
MD8703252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer