Individual
CAMILLA SUSAN KEADY-CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 COMMUNITY WAY, LANCASTER, PA 17603-2301
(717) 393-0425
(717) 735-6009
Mailing address
625 COMMUNITY WAY, LANCASTER, PA 17603-2301
(717) 393-0425
(717) 735-6009
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC016064
PA
235Z00000X
Speech-Language Pathologist
OC016064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037166130001
—
PA
Enumeration date
03/26/2019
Last updated
02/23/2022
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