Individual
DR. PATRICIA CORNELIOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-1607
Mailing address
1585 3RD ST, LEESVILLE, LA 71459-5102
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1273
LA
Other
Enumeration date
04/19/2014
Last updated
06/27/2022
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