Provider Demographics
NPI:1447381496
Name:CORNELL, JOY LYNN (MFT)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:LYNN
Last Name:CORNELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:LYNN
Other - Last Name:DANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2547 BELLEVUE WAY
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550
Mailing Address - Country:US
Mailing Address - Phone:661-733-6911
Mailing Address - Fax:
Practice Address - Street 1:1817 HIDEAWAY PL
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-5109
Practice Address - Country:US
Practice Address - Phone:661-733-6911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist