Individual
BENJAMIN CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
31946 MISSION TRAIL, SUITE B, LAKE ELSINORE, CA 92530
(951) 245-7663
Mailing address
1144 W BLAINE ST APT 202, RIVERSIDE, CA 92507-7677
(860) 803-3527
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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