Individual
MR. DARRYL CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSA
Contact information
Practice address
11457 SHOEMAKER, DETROIT, MI 48213
(313) 921-4700
Mailing address
11457 SHOEMAKER, DETROIT, MI 48213
(313) 921-4700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401004914
MASTERS
MI
Enumeration date
04/17/2007
Last updated
07/08/2007
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