Individual
DENNIS CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1948
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100099760
—
KY
Enumeration date
10/02/2008
Last updated
03/10/2010
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