Provider Demographics
NPI:1124690870
Name:CORY, MARIAH R
Entity type:Individual
Prefix:MS
First Name:MARIAH
Middle Name:R
Last Name:CORY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N PARK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2941
Mailing Address - Country:US
Mailing Address - Phone:484-516-2330
Mailing Address - Fax:
Practice Address - Street 1:20 N FRONT ST
Practice Address - Street 2:
Practice Address - City:BALLY
Practice Address - State:PA
Practice Address - Zip Code:19503-9605
Practice Address - Country:US
Practice Address - Phone:267-461-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health