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1598438525
CARISSA CORNWALL
FORT WAYNE, IN
NPI
1598438525
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IN RBT-21-177125)
Enumeration Date
2021-07-27
Last Update Date
2021-07-27
Business Address
CARISSA CORNWALL RBT
4422 E STATE BLVD
FORT WAYNE, IN 46815-6917
Phone number: 260-471-9263
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Mailing Address
CARISSA CORNWALL RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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