Provider Demographics
NPI:1154459865
Name:CORNETT, ROB ALLEN (BS)
Entity Type:Individual
Prefix:MR
First Name:ROB
Middle Name:ALLEN
Last Name:CORNETT
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 CAVE MILL CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8632
Mailing Address - Country:US
Mailing Address - Phone:931-648-9304
Mailing Address - Fax:
Practice Address - Street 1:3737 CAVE MILL CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-8632
Practice Address - Country:US
Practice Address - Phone:931-648-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker