Tanja Dawn Cornelison, LCPC Valid NPI

Individual provider · Mental Health Counselor · Chubbuck, ID

NPI

1215188479

Type

Individual (Type 1)

Primary specialty

Mental Health Counselor (Counselor)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

101YM0800X

License number

LCPC-6510 (ID)

Sex

Female

Sole proprietor

No

Enumerated

2008-10-07

Last updated

2026-06-02