Provider Demographics
NPI:1194104612
Name:DUPUIS, CORINNE
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:DUPUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1113
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-1113
Mailing Address - Country:US
Mailing Address - Phone:602-714-1146
Mailing Address - Fax:
Practice Address - Street 1:12951 W AVALON DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6759
Practice Address - Country:US
Practice Address - Phone:623-547-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant