Individual
CORNEISHA BLISSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1398 SW 160TH AVE STE 401, SUNRISE, FL 33326-1905
(855) 444-5664
Mailing address
2430 NE 8TH TER, POMPANO BEACH, FL 33064-6462
(229) 488-6139
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5894
LA
103K00000X
Behavior Analyst
Primary
—
—
103TF0000X
Family Psychologist
1234
LA
103TS0200X
School Psychologist
987456A
AL
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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