Corneilia L Ervins

NPI #1285194712 in Rockford, Illinois

Provider Information

NPI Number: 1285194712
Entity Type: Individual
Name: Corneilia L Ervins
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Mar 21, 2019
Last Updated: Apr 5, 2019

Practice Location

Address: 5225 LINDEN RD APT 7207
City: Rockford
State: Illinois
ZIP Code: 61109-6419
Phone: (815) 501-7711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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