Healthcare Provider Details

I. General information

NPI: 1922677582
Provider Name (Legal Business Name): SARAH K CORNMAN MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N 8TH ST
LEBANON PA
17046-5011
US

IV. Provider business mailing address

230 LILLEIGH CT
MAURERTOWN VA
22644-2583
US

V. Phone/Fax

Practice location:
  • Phone: 717-468-1684
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: