Individual
MEGAN RUSSELL CANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
129 NE PARKS VIEW CT, LEES SUMMIT, MO 64064-2353
(816) 478-9996
Mailing address
1409 SPRUCE DR, GREENWOOD, MO 64034-8687
(816) 668-5242
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2010000742
MO
Other
Enumeration date
01/07/2010
Last updated
02/23/2012
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