Provider Demographics
NPI:1669980926
Name:CORREIA, CORINNA MARIE (PHD)
Entity type:Individual
Prefix:
First Name:CORINNA
Middle Name:MARIE
Last Name:CORREIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NORTHWEST HWY APT 108
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-3047
Mailing Address - Country:US
Mailing Address - Phone:619-246-2179
Mailing Address - Fax:
Practice Address - Street 1:4433 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1820
Practice Address - Country:US
Practice Address - Phone:847-568-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist