Individual
COREY RAYBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
18764 PRINE RD # B, CITRONELLE, AL 36522-4922
(251) 656-1960
Mailing address
18764 PRINE RD # B, CITRONELLE, AL 36522-4922
(251) 656-1960
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1531
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
02/05/2014
Last updated
11/07/2023
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