Provider Demographics
NPI:1740705144
Name:CORBIN, KATHERINE M (SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:CORBIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:SOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:980 ROOSEVELT STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3670
Mailing Address - Country:US
Mailing Address - Phone:949-333-6400
Mailing Address - Fax:
Practice Address - Street 1:980 ROOSEVELT STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3670
Practice Address - Country:US
Practice Address - Phone:949-333-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist