Individual
MANDY CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
625 N 6TH ST, PHOENIX, AZ 85004-2155
(602) 406-8270
(602) 406-0680
Mailing address
625 N 6TH ST, PHOENIX, AZ 85004-2155
(602) 406-8270
(602) 406-0680
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-11979
AZ
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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