Individual
NATALIE CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
15990132 CSAC
Contact information
Practice address
N2150 KESAEHKAHTEK RD, GRESHAM, WI 54128-9602
(715) 799-3835
Mailing address
N7988 HUNTINGTON RD, GRESHAM, WI 54128
(715) 851-5453
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15990-132
WI
Other
Enumeration date
12/16/2015
Last updated
03/17/2018
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