Provider Demographics
NPI:1407229990
Name:CANN, ANITA (MHS)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:
Last Name:CANN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 HIGHWAY 44
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-8128
Mailing Address - Country:US
Mailing Address - Phone:225-715-8274
Mailing Address - Fax:225-647-8193
Practice Address - Street 1:8155 HIGHWAY 44
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-8128
Practice Address - Country:US
Practice Address - Phone:225-715-8274
Practice Address - Fax:225-647-8193
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor