Healthcare Provider Details

I. General information

NPI: 1588067490
Provider Name (Legal Business Name): CLAUDIA GRACE CANALES PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 HOLLY LN
SALINA KS
67401-8452
US

IV. Provider business mailing address

217 FLINT LOCK RD
CHARLESTON WV
25314-2481
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-4930
  • Fax: 785-452-4932
Mailing address:
  • Phone: 785-452-4930
  • Fax: 785-452-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1347
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2554
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: