Jessica Nicole Cannady, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Marshall, IL
NPI 1689015331 · NPPES record last updated Jul 10, 2013
Key facts
- NPI
- 1689015331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.011111 (IL)
- Practice address
- 71 Archer Ave
Marshall, IL 62441-1065 - Phone
- (217) 251-1624
- NPI assigned
- Jul 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.011111 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.011111 | IL | Yes |
Addresses
Primary practice location
71 Archer Ave
Marshall, IL 62441-1065
Mailing address
71 Archer Ave
Marshall, IL 62441-1065
Other providers in Marshall, IL
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- Emma Brown
- Burnsides Community Health Center
- Burnsides Community Health Center, NFP
- Core Wellness Physical Therapy, PLLC
- County of Clark
- Anita Yvonne Eirhart
- Jessica Lynn Engledow
- Eyes on Main PLLC
All providers in Marshall, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.