Provider Demographics
NPI:1356743009
Name:MARY K CORBIN
Entity type:Organization
Organization Name:MARY K CORBIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK SPECIALIST I
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:319-430-3882
Mailing Address - Street 1:826 RUNDELL ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6254
Mailing Address - Country:US
Mailing Address - Phone:319-430-3882
Mailing Address - Fax:
Practice Address - Street 1:826 RUNDELL ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6254
Practice Address - Country:US
Practice Address - Phone:319-430-3882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03129273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit