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NPI Code Detail

MEDICARE: CYNTHIA MARIE CANNER LGPC

MEDICARE: CYNTHIA MARIE CANNER LGPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLGP9326MD

General Provider Information

NPI Number : 1932765732
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA MARIE CANNER LGPC
Provider Business Mailing Address
First Line : PO BOX 1159
Second Line :
City : SEVERNA PARK
State : MD
Zip : 21146-8159
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17826 NEW HAMPSHIRE AVE
Second Line :
City : ASHTON
State : MD
Zip : 20861-9781
Country : US
Telephone Number : 800-491-5639
Fax Number : 301-774-3678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2019
Last Update Date : 05/16/2019

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Directions to “ CYNTHIA MARIE CANNER LGPC” Practice Location

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