Provider Demographics
NPI:1508038795
Name:CORNELIA, BARBARA (MA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CORNELIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N KEEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3440
Mailing Address - Country:US
Mailing Address - Phone:800-471-8592
Mailing Address - Fax:
Practice Address - Street 1:102 N KEEL RIDGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3440
Practice Address - Country:US
Practice Address - Phone:800-471-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01113231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist