Individual
JONATHAN LEE CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
262 CHAPLIN RD, BLOOMFIELD, KY 40008-7125
(646) 418-4043
Mailing address
262 CHAPLIN RD, BLOOMFIELD, KY 40008-7125
(646) 418-4043
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
246179
KY
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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