Individual
SARA GRACE CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
399 HOSPITAL LN, TERRE HAUTE, IN 47802-4394
(812) 645-2308
(317) 520-8200
Mailing address
7901 E 88TH ST, INDIANAPOLIS, IN 46256-1235
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-72758
IN
106S00000X
Behavior Technician
RBT-20-125995
IN
Other
Enumeration date
07/01/2020
Last updated
05/13/2025
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