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General NPI Number Information
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NPI Number | 1316076011
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Entity Type | Individual
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Provider Name | THOMAS W MCCANN M.S.,ED.D
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 7315 DIXIE HWY
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City | FLORENCE
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State | KY
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Zip | 41042-2126
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Country | US
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Telephone | 859-282-0119
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Fax | 859-282-8018
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Provider Business Mailing Address
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Address Line | 7315 DIXIE HWY
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City | FLORENCE
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State | KY
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Zip | 41042-2126
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Country | US
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Telephone | 859-282-0119
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Fax | 859-282-8018
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 14
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License Number State | KY
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