Individual
MS. AMELIA D. CANALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3534 BEECAVE RD, SUITE #114, AUSTIN, TX 78746
(512) 799-4091
Mailing address
2714 TETNER TRAIL, AUSTIN, TX 78704
(512) 799-4091
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
35123
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009KX
BLUE CROSS BLUE SHIELD #
TX
Enumeration date
10/02/2006
Last updated
04/21/2016
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