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Individual

MARK JAMES CORNMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
3106 RIDGE RD, HARTWELL, GA 30643-4121
(706) 371-6196
Mailing address
3106 RIDGE RD, HARTWELL, GA 30643-4121
(706) 371-6196

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005713
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12317350
ATENA
GA
Enumeration date
12/11/2011
Last updated
12/11/2011
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