Individual
ALICIA CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5840 BALCONES DR STE 200, AUSTIN, TX 78731-4246
(512) 402-2940
Mailing address
3001 SCOFIELD RIDGE PKWY, AUSTIN, TX 78727-6398
(325) 812-4231
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
92693
TX
Other
Enumeration date
04/21/2019
Last updated
09/01/2023
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