Individual
CARLYE ANN CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8030 LA MESA BLVD, LA MESA, CA 91942
(619) 567-9448
(619) 722-4213
Mailing address
110 DAVIDS WAY, WAKEFIELD, RI 02879
(401) 714-4269
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19489
CA
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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