Doctor Name: | ASHLEY ANN CANUP |
NPI Number: | 1063799591 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1913 Meade St North Bend, OR - 974593432 |
Business Phone Number: | 5417564508 |
Business Fax Number: | 5417564550 |
Mailing Address: | 1913 Meade St, NORTH BEND |
State: | OR |
Postal Code: | 974593432 |
Phone Number: | 5417564508 |
Fax Number: | 5417564550 |
NPI Enumeration Date: | 11/11/2011 |
NPI Last Update Date: | 11/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |