Individual
THEA SUE CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1050 E BROADWAY, MONONA, WI 53716-4023
(608) 890-6110
Mailing address
1050 E BROADWAY, MONONA, WI 53716-4023
(608) 890-6110
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
528308
MN
235Z00000X
Speech-Language Pathologist
Primary
6199
WI
Other
Enumeration date
07/07/2022
Last updated
12/13/2024
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