Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY5442 | FL |
Y | 103T00000X | Psychologist | PY5442 | FL |
NPI | 1013077783 |
---|---|
Provider Name | Dr. Andrea S. Corn |
First Address | Boca Raton, FL 33432 |
Second Address | Boca Raton, FL 33432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 14/05/2021 |