Individual
RIVA CORNELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1403 43RD AVE., SUITE D, GULFPORT, MS 39501-3950
(601) 215-5545
(228) 241-0326
Mailing address
1403 43RD AVE., SUITE D, GULFPORT, MS 39501
(601) 215-5545
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
MS
Other
Enumeration date
02/17/2021
Last updated
04/05/2023
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