Individual
BENJAMIN CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3336 S CLAY ST, ENGLEWOOD, CO 80110-1928
(818) 933-1562
Mailing address
640 LINDEN CRK, MORROW, OH 45152-8451
(818) 933-1562
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
60906097
WA
Other
Enumeration date
02/02/2015
Last updated
01/22/2019
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