Provider Demographics
NPI:1881034205
Name:CANNAVO, CHARITY (MA)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:CANNAVO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13719 EVE MARGARET CT
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-2318
Mailing Address - Country:US
Mailing Address - Phone:434-430-0989
Mailing Address - Fax:
Practice Address - Street 1:13719 EVE MARGARET CT
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-2318
Practice Address - Country:US
Practice Address - Phone:434-430-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-29
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor