Provider Demographics
NPI:1306076575
Name:KORS, ALICIA CHRISTEL (MA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:CHRISTEL
Last Name:KORS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4913 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-3411
Mailing Address - Country:US
Mailing Address - Phone:273-752-1290
Mailing Address - Fax:
Practice Address - Street 1:4913 N 21ST ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-3411
Practice Address - Country:US
Practice Address - Phone:273-752-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60096657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist