Provider Demographics
NPI:1740431782
Name:CORNETT, PATRICIA F (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:F
Last Name:CORNETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 REGAL CIR
Mailing Address - Street 2:APT. D
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4684
Mailing Address - Country:US
Mailing Address - Phone:940-391-8253
Mailing Address - Fax:
Practice Address - Street 1:560 SPARKS CTR
Practice Address - Street 2:1720 7TH AVE. S.
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:940-391-8253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1616103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical