Individual
DEIDRE MICHELLE CANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
PO BOX 8, WADDY, KY 40076-0008
(502) 548-5482
Mailing address
PO BOX 8, WADDY, KY 40076-0008
(502) 548-5482
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253433
KY
Other
Enumeration date
05/17/2011
Last updated
12/10/2024
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