Organization
COMPREHENSIVE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA J CORNELL PSY D (OWNER)
(570) 643-0222
Entity
Organization
Contact information
Practice address
274 ROUTE 970, BLAKESLEE SQUARE, BLAKESLEE, PA 18610-0604
(570) 643-0222
(570) 643-0224
Mailing address
274 ROUTE 940, PO BOX 604, BLAKESLEE, PA 18610-0604
(570) 643-0222
(570) 643-0224
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016217
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101894788
—
PA
Enumeration date
03/01/2011
Last updated
08/04/2011
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