Individual
KIMBERLY PAIGE CORNMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
4935 HILLEGAS RD STE 200, FORT WAYNE, IN 46818-1934
(260) 338-1241
Mailing address
3710 FLOWING BROOK DR, FORT WAYNE, IN 46818-8509
(260) 403-7056
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28812
—
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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