Provider Demographics
NPI:1992000590
Name:CHRISTY CANADY, LLC
Entity Type:Organization
Organization Name:CHRISTY CANADY, LLC
Other - Org Name:MORE THAN WORDS SPEECH THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CANADY
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:706-364-1486
Mailing Address - Street 1:601 N BELAIR SQ STE 19
Mailing Address - Street 2:SUITE 19
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4324
Mailing Address - Country:US
Mailing Address - Phone:706-364-1486
Mailing Address - Fax:706-364-1487
Practice Address - Street 1:601 N BELAIR SQ STE 19
Practice Address - Street 2:SUITE 19
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4324
Practice Address - Country:US
Practice Address - Phone:706-364-1486
Practice Address - Fax:706-364-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA729022744AMedicaid