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Individual

AMELIA CORNUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15 10TH AVE, SHALIMAR, FL 32579-1340
(850) 362-6824
Mailing address
933 DENTON BLVD NW UNIT B, FORT WALTON BEACH, FL 32547-4627

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/16/2026
Last updated
01/16/2026
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