TANJA DAWN CORNELISON

POCATELLO, ID
NPI1215188479
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: ID  LPC-3452)
Enumeration Date2008-10-07
Last Update Date2008-10-07
Business Address
-- TANJA DAWN CORNELISON LPC
210 E CENTER ST STE B
POCATELLO, ID 83201-6326
Phone number: 208-234-2600
Mailing Address
-- TANJA DAWN CORNELISON LPC
5140 CONSTITUTION AVE
CHUBBUCK, ID 83202-3076
Phone number: 208-604-0155
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