Individual provider · NPI-1

Stacie Cannell

Technician/Technologist · Toledo, OH

NPI number1003420639
StatusActive
Last updated in NPPESSep 21, 2022

Details

NPI
1003420639
Entity type
Individual (NPI-1)
Name
Stacie Cannell
Sex
Female
Sole proprietor
No
Enumeration date
Sep 1, 2020
Certification date
Sep 21, 2022
Last updated
Sep 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156F00000X Technician/Technologist––Yes
106S00000X Behavior Technician––

Practice location

5151 Monroe St Ste 232
Toledo, OH 43623-3461

Phone 419-574-9290 · Fax 248-712-4381

Mailing address

5151 Monroe St Ste 232
Toledo, OH 43623-3461

Phone 419-574-9290 · Fax 248-712-4381

Other practice locations

1719 Metropolitan Ave
Leavenworth, KS 66048-1124

Phone 913-250-5634

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