Individual
CHIQUITHA CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3130 S 11TH ST STE 105, NILES, MI 49120-4736
(574) 274-0152
Mailing address
3130 S 11TH ST STE 105, NILES, MI 49120-4736
(574) 274-0152
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
6301015882
MI
103T00000X
Psychologist
6301015882
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301015882
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301015882
MI
103TP0814X
Psychoanalysis Psychologist
6301015882
MI
103TP2701X
Group Psychotherapy Psychologist
6301015882
MI
104100000X
Social Worker
6801095307
MI
2084P0800X
Psychiatry Physician
6830101788
MI
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/21/2011
Last updated
01/21/2021
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