Individual
KATHLEEN W CORMIER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
625 W HILLSIDE AVE, RUTH CLINIC, PRESCOTT, AZ 86301-1936
(928) 445-5211
(928) 776-8484
Mailing address
642 DAMERON DR, PRESCOTT, AZ 86301-2411
(928) 445-5211
(928) 776-8484
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LISAC1004
AZ
Other
Enumeration date
11/15/2005
Last updated
07/08/2007
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