Provider Demographics
NPI:1801134887
Name:CORNFIELD, ELIZABETH MARIE (BS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:CORNFIELD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3351 ASPEN GROVE DR STE 350
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2912
Mailing Address - Country:US
Mailing Address - Phone:615-721-5921
Mailing Address - Fax:
Practice Address - Street 1:3351 ASPEN GROVE DR STE 350
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2912
Practice Address - Country:US
Practice Address - Phone:615-721-5921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN492106S00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician