Provider Demographics
NPI:1609467521
Name:COREA, LAUREL (DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:
Last Name:COREA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 FOLSOM LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2320
Mailing Address - Country:US
Mailing Address - Phone:631-375-9655
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 303
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3148
Practice Address - Country:US
Practice Address - Phone:301-231-7138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2025-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist