Provider Demographics
NPI:1851843726
Name:KORNACKA, MAGDALENA I (MFT)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:KORNACKA
Suffix:I
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 S MAIN ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4871
Mailing Address - Country:US
Mailing Address - Phone:215-622-9628
Mailing Address - Fax:
Practice Address - Street 1:350 S MAIN ST
Practice Address - Street 2:SUITE 306
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4871
Practice Address - Country:US
Practice Address - Phone:215-622-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist