Organization
SONYA L CORNWELL PHD CLINICAL PSYCHOLOGIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA L CORNWELL PHD (PHD AND OWNER)
(918) 708-9558
Entity
Organization
Contact information
Practice address
310 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3824
(918) 708-9558
(918) 708-9580
Mailing address
310 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3824
(918) 708-9558
(918) 708-9580
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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