Individual
CAMILLE CORNELIOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3050 W AGUA FRIA FWY STE 150, PHOENIX, AZ 85027-3998
(623) 332-8002
(623) 234-4774
Mailing address
3050 W AGUA FRIA FWY STE 150, PHOENIX, AZ 85027-3998
(623) 332-8002
(623) 234-4774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-21261
AZ
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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