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Individual

MRS. KARLA MARIE CORNELIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CCC/SLP

Contact information

Practice address
2103 US HIGHWAY 522 S, MC VEYTOWN, PA 17051-9429
(814) 542-8630
Mailing address
2103 US HIGHWAY 522 S, MC VEYTOWN, PA 17051-9429
(814) 542-8630

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457329294
OUTPATIENT THERAPY FACILITY
PA
Enumeration date
07/08/2013
Last updated
07/08/2013
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