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General NPI Number Information
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NPI Number | 1174615678
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Entity Type | Individual
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Provider Name | ASHLEY ALVARADO CANNAN M.A., L.P.C., R.P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 464 CHEROKEE AVE SE SUITE 202
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City | ATLANTA
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State | GA
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Zip | 30312-3260
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Country | US
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Telephone | 404-354-7786
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Fax | 775-313-0859
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Provider Business Mailing Address
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Address Line | 889 COMMONWEALTH AVE SE
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City | ATLANTA
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State | GA
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Zip | 30312-3663
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Country | US
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Telephone | 404-354-7786
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Fax | 775-313-0859
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00341800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC005408
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License Number State | GA
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