Individual
ANTONETTE CORNELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11027 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601-2431
(818) 985-8323
Mailing address
11027 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601-2431
(818) 985-8323
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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