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NPI Code Detail

MEDICARE: CARA MAE CANNY

MEDICARE: CARA MAE CANNY
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1780147611
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARA MAE CANNY
Provider Business Mailing Address
First Line : 1431 W NINE MILE RD UNIT 1207
Second Line :
City : PENSACOLA
State : FL
Zip : 32534-5356
Country : US
Telephone Number : 205-242-9891
Fax Number :
Provider Business Practice Location Address
First Line : 114 3RD ST SE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5401
Country : US
Telephone Number : 850-243-6134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2019
Last Update Date : 04/08/2019

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Directions to “ CARA MAE CANNY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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