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Individual

JUSTIN ROSS CORNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA, LADAC II

Contact information

Practice address
201 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-9711
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1535
TN
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
08/07/2018
Last updated
03/11/2024
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