Provider Demographics
NPI:1912210543
Name:KUTNER, CORIN ALISA (MS)
Entity Type:Individual
Prefix:MISS
First Name:CORIN
Middle Name:ALISA
Last Name:KUTNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PARK PL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4129
Mailing Address - Country:US
Mailing Address - Phone:914-337-6357
Mailing Address - Fax:
Practice Address - Street 1:15 PARK PL
Practice Address - Street 2:SUITE 2
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4129
Practice Address - Country:US
Practice Address - Phone:914-337-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2010-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58 020241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist