Individual
DR. SONYA LYNN CORNWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
310 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3824
(817) 307-0949
Mailing address
310 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3824
(918) 708-9558
(918) 708-9580
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
1309
OK
103TB0200X
Cognitive & Behavioral Psychologist
1309
OK
103TC0700X
Clinical Psychologist
Primary
1309
OK
103TC2200X
Clinical Child & Adolescent Psychologist
1309
OK
103TH0100X
Health Service Psychologist
1309
OK
Other
Enumeration date
05/23/2018
Last updated
09/25/2019
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