Provider Demographics
NPI:1538424882
Name:VANCE, CORINNE MARGUERITE (MA)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:MARGUERITE
Last Name:VANCE
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 1:860 FINCHER RD
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128-6237
Mailing Address - Country:US
Mailing Address - Phone:703-371-5252
Mailing Address - Fax:
Practice Address - Street 1:860 FINCHER RD
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-6237
Practice Address - Country:US
Practice Address - Phone:703-371-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6050549101YM0800X
ALLPC03936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health