| NPI | 1518425230 |
|---|---|
| Doing Business As | KAITLYN CORNELL |
| Entity Type | Organization |
| Authorized Contact | KAITLYN CORNELL Owner/Provider 217-377-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2025-12-16 |