Provider Demographics
NPI:1851614556
Name:CANNADY, ORA (MED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ORA
Middle Name:
Last Name:CANNADY
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 WENDY LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1863
Mailing Address - Country:US
Mailing Address - Phone:919-592-1684
Mailing Address - Fax:
Practice Address - Street 1:3904 WENDY LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1863
Practice Address - Country:US
Practice Address - Phone:919-862-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 12262235Z00000X
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist