Individual
MS. MARY JO CANADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-A/SP
Contact information
Practice address
6910 N MAIN ST UNIT 10, GRANGER, IN 46530-9681
(574) 247-6047
(574) 247-6060
Mailing address
6910 N MAIN ST UNIT 10, GRANGER, IN 46530-9681
(574) 247-6047
(574) 247-6060
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22004688A
IN
237600000X
Audiologist-Hearing Aid Fitter
Primary
23002434A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200014070
—
IN
Enumeration date
07/22/2008
Last updated
07/22/2008
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