Individual
MS. ELLEN S CANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 863-2021
Mailing address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 863-2021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0026
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21115
NC BLUE CROSS BLUE SHIELD
NC
05
—
7321115
—
NC
Enumeration date
01/30/2007
Last updated
07/09/2007
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