Individual
MR. BRUCE WILLIAM CORNWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1029 NW 23RD AVE, GAINESVILLE, FL 32609-3469
(352) 376-8788
Mailing address
444 SE 5TH AVE, MELROSE, FL 32666-5417
(352) 226-5566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS20000
CA
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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