Roan, Corey Summerlin

Roan, Corey Summerlin is an individual health care provider with primary practice located at 5057 Frink Ave , San Diego CA 92117-1212. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Roan, Corey Summerlin can be contacted via phone (757) 288-9512.

Contact Information

Primary practice address
5057 Frink Ave San Diego CA 92117-1212
Phone: (757) 288-9512
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation 225XP0019X 0119005572 Virginia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X

Profile Details

NPI number 1730453747
LBN Legal business name Roan, Corey Summerlin
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2012
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730453747 NPPES
Virginia Other 0119005572 LISCENSE NUMBER

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