Provider Demographics
NPI:1063177798
Name:PYNE, CORINNE (AUD)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:PYNE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N VEITCH ST UNIT 1514
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6209
Mailing Address - Country:US
Mailing Address - Phone:703-298-4162
Mailing Address - Fax:
Practice Address - Street 1:8120 GATEHOUSE RD FL 1
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1204
Practice Address - Country:US
Practice Address - Phone:703-524-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001803237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
14419288OtherASHA
VA2201001803OtherSTATE LICENSE