Individual
HEATHER ANNE CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2760 FIELDSTONE RD, COLORADO SPRINGS, CO 80919
(719) 203-6903
Mailing address
2760 FIELDSTONE RD, COLORADO SPRINGS, CO 80919-3100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59888
CO
106S00000X
Behavior Technician
RBT-17-40949
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-40949
BACB
—
Enumeration date
12/29/2017
Last updated
06/28/2022
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