Provider Demographics
NPI:1568635563
Name:MANN, CORINNE LEE (AUD)
Entity Type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:LEE
Last Name:MANN
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 1:10605 COSTELLO DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1402
Mailing Address - Country:US
Mailing Address - Phone:714-505-3886
Mailing Address - Fax:
Practice Address - Street 1:17870 CASTLETON ST STE 208
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-5877
Practice Address - Country:US
Practice Address - Phone:626-723-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1390231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist