Provider Demographics
NPI:1811775091
Name:PAUL, CORINNE A (MMFT)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:A
Last Name:PAUL
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:A
Other - Last Name:WISEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11603 SHELBYVILLE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1371
Mailing Address - Country:US
Mailing Address - Phone:502-276-5736
Mailing Address - Fax:
Practice Address - Street 1:11603 SHELBYVILLE RD STE 5
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1371
Practice Address - Country:US
Practice Address - Phone:502-276-5736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist