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Individual

ANTOINETTE S CORDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
342 ALLEN ST, YELLOW SPRINGS, OH 45387-1306
(937) 776-2836
Mailing address
342 ALLEN ST, YELLOW SPRINGS, OH 45387-1306
(937) 776-2836

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1835
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0356065
OH
Enumeration date
01/09/2007
Last updated
11/11/2020
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