Provider Demographics
NPI:1578046058
Name:CULIE, CORBI
Entity Type:Individual
Prefix:
First Name:CORBI
Middle Name:
Last Name:CULIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:PEGGS
Mailing Address - State:OK
Mailing Address - Zip Code:74452-0010
Mailing Address - Country:US
Mailing Address - Phone:918-931-7969
Mailing Address - Fax:
Practice Address - Street 1:415 HIGHWAY 377 S STE 200
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-5140
Practice Address - Country:US
Practice Address - Phone:940-464-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist