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Individual

DR. BRENDA JEAN MCCANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUDCCCA

Contact information

Practice address
1806 E PARKDALE AVE, SUITE 3, MANISTEE, MI 49660-9363
(231) 398-9536
(231) 398-9541
Mailing address
1806 E PARKDALE AVE, SUITE 3, MANISTEE, MI 49660-9363
(231) 398-9536
(231) 398-9541

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000332
MI
231HA2500X
Assistive Technology Supplier Audiologist
1601000332
MI
237600000X
Audiologist-Hearing Aid Fitter
1601000332
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540E102660
BCBS MICHIGAN
MI
01
640E126000
BCBS MICHIGAN
MI
Enumeration date
02/13/2008
Last updated
10/09/2015
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