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

LicenseStateTypeSpecialty
146.011111ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Marshall, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.