Provider Demographics
NPI:1295948511
Name:CORNETT, MARGARET B (MA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:B
Last Name:CORNETT
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 1:2876 N CAREFREE CIR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-7593
Mailing Address - Country:US
Mailing Address - Phone:928-526-4972
Mailing Address - Fax:
Practice Address - Street 1:2876 N CAREFREE CIR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-7593
Practice Address - Country:US
Practice Address - Phone:928-526-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA 485237600000X
AZSLPL1026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist