Provider Demographics
NPI:1922678424
Name:CORBIN, CAYLEE NICOLE (RBT)
Entity Type:Individual
Prefix:
First Name:CAYLEE
Middle Name:NICOLE
Last Name:CORBIN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1194 W SOUTH JORDAN PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5508
Mailing Address - Country:US
Mailing Address - Phone:801-302-3801
Mailing Address - Fax:801-302-7248
Practice Address - Street 1:308 GREENVILLE BLVD SE STE B1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5758
Practice Address - Country:US
Practice Address - Phone:252-341-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician