Individual
WILLIAM TYLER CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 CRESTLINE AVE, CINCINNATI, OH 45205-2207
(513) 446-5756
Mailing address
330 CRESTLINE AVE, CINCINNATI, OH 45205-2207
(513) 446-5756
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
11/24/2023
Last updated
11/24/2023
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