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General NPI Number Information
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NPI Number | 1114568797
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Entity Type | Individual
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Provider Name | KENDRA SHARI CANADY LAMFT
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Gender | Female
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 4425 W OLIVE AVE STE 151
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City | GLENDALE
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State | AZ
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Zip | 85302-3855
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Country | US
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Telephone | 602-456-4817
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Fax |
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Provider Business Mailing Address
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Address Line | 13421 N 43RD AVE APT 3100
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City | PHOENIX
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State | AZ
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Zip | 85029-1042
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Country | US
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Telephone | 480-519-6740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LAMFT-10654
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License Number State | AZ
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