Provider Demographics
NPI:1750616702
Name:LAUGHLIN, MARY CANADY
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CANADY
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 SIM CANADY ROAD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8780
Mailing Address - Country:US
Mailing Address - Phone:910-425-9885
Mailing Address - Fax:
Practice Address - Street 1:6520 SIM CANADY ROAD
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8780
Practice Address - Country:US
Practice Address - Phone:910-425-9885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency