| Doctor Name: | KAMI CORNWALL |
| NPI Number: | 1124418520 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHCA |
| License Number: | MC60489971 |
| Business Practice Address: | 1205 Se Professional Mall Blvd Suite 109 Pullman, WA - 991635423 |
| Business Phone Number: | 5094323925 |
| Business Fax Number: | |
| Mailing Address: | 1205 Se Bishop Blvd, Suite 109 PULLMAN |
| State: | WA |
| Postal Code: | 991635652 |
| Phone Number: | 5094323925 |
| Fax Number: | |
| NPI Enumeration Date: | 01/23/2015 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MC60489971 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |