Individual
MS. MARISA GWALTNEY CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
318 DONNELLY ST, MOUNTAIN CITY, TN 37683-1510
(423) 727-2100
(423) 727-2110
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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