Individual
MELANIE R CANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-3636
Mailing address
4935 S 1750 E, VICTOR, ID 83455-4304
(585) 733-0557
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT-1631
WY
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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