Provider Demographics
NPI:1720758352
Name:CORBIN, TESSA (HID)
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:CORBIN
Suffix:
Gender:F
Credentials:HID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-4576
Mailing Address - Country:US
Mailing Address - Phone:612-824-8698
Mailing Address - Fax:
Practice Address - Street 1:7745 2ND AVE S
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-4576
Practice Address - Country:US
Practice Address - Phone:612-294-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2894237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist