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General NPI Number Information
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NPI Number | 1992156129
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Entity Type | Individual
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Provider Name | MISS RACHEL CORNELIUS
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Gender | Female
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 75 PRINGLE WAY STE 300
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City | RENO
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State | NV
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Zip | 89502-8425
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Country | US
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Telephone | 775-982-3960
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Fax | 775-982-3727
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Provider Business Mailing Address
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Address Line | 1155 MILL ST MS M14
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City | RENO
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State | NV
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Zip | 89502-1576
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Country | US
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Telephone | 775-982-5262
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Fax | 775-982-5496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0004881
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0898
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License Number State | NV
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