Provider Demographics
NPI:1497841274
Name:ALLERDICE, CORNELIA NONI (MS, CADCI)
Entity Type:Individual
Prefix:
First Name:CORNELIA
Middle Name:NONI
Last Name:ALLERDICE
Suffix:
Gender:F
Credentials:MS, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3513
Practice Address - Country:US
Practice Address - Phone:541-342-8437
Practice Address - Fax:541-342-1639
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health