Individual
MARISSA CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3311
Mailing address
4540 NICKLAUS DR APT 208, CHAMPAIGN, IL 61822-1503
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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