Provider Demographics
NPI:1740840917
Name:MOTTERN, CORRIN ELIZABETH (MS)
Entity type:Individual
Prefix:
First Name:CORRIN
Middle Name:ELIZABETH
Last Name:MOTTERN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CORRIN
Other - Middle Name:ELIZABETH
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPT OF SPEECH PATHOLOGY & AUDIOLOGY BOX 3887-DUMC
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIRCLE
Practice Address - Street 2:DEPT OF SPEECH PATHOLOGY & AUDIOLOGY
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-684-6271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007012231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist