MEDICARE: MS. RONNI DANIELLE CANNADY RDH

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
1	1041C0700X	Clinical Social Worker
2	171M00000X	Case Manager/Care Coordinator		MD

General Provider Information

NPI Number	:	1427742402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RONNI DANIELLE CANNADY RDH

Provider Business Mailing Address
First Line	:	1418 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5615
Country	:	US
Telephone Number	:	202-796-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 GOOD HOPE ROAD SE
Second Line	:
City	:	WASHINGTON
State	:	MD
Zip	:	21117
Country	:	US
Telephone Number	:	443-277-3285
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/23/2023

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