Individual
JENNA CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
6033 FASHION POINT DR STE 100, SOUTH OGDEN, UT 84403-4848
(605) 271-2690
Mailing address
1105 W RUSSELL ST, SIOUX FALLS, SD 57104-1322
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-432539
UT
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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