Provider Demographics
NPI:1255091773
Name:CORBETT, KELSEY ELIZABETH (DACM)
Entity type:Individual
Prefix:MISS
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:CORBETT
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:786 DEL RIO AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2321
Mailing Address - Country:US
Mailing Address - Phone:484-678-8977
Mailing Address - Fax:
Practice Address - Street 1:523 ENCINITAS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3739
Practice Address - Country:US
Practice Address - Phone:484-678-8977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18634171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist