Individual
ALEXIS M CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
133 E 9TH ST, OSWEGO, NY 13126-1617
(315) 236-3059
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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