Individual
VINCENT CORNELLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
550 MUNSON AVE, TRAVERSE CITY, MI 49686-3580
(231) 935-8540
(231) 935-8544
Mailing address
550 MUNSON AVE, TRAVERSE CITY, MI 49686-3580
(231) 935-8540
(231) 935-8544
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301002081
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VC002081
BLUE CROSS
MI
Enumeration date
01/12/2007
Last updated
07/09/2007
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