Individual
CAITLYN ALISON GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49 LARCH LN, CENTERVILLE, MA 02632-2883
(774) 994-2555
Mailing address
49 LARCH LN, CENTERVILLE, MA 02632-2883
(774) 994-2555
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2043-SP-SA
MA
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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