Provider Information for 1306085253
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Mrs. FULIVIA ELMA CANNADY MSCP,NCC,LPC
Other Names:Former Name:Miss FULIVIA ELMA BANKS MSCP,NCC,LPCSex: Female
NPI: 1306085253
Last Updated: 2009-02-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1306085253 | ||||||||||||
| Enumeration Date | 2009-02-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 113B WILLOW BROOK DR CLINTON, MS 39056-5802 United States Phone: 601-832-8264 | Fax: | ||||||||||||
| Primary Practice Address | 113B WILLOW BROOK DR CLINTON, MS 39056-5802 United States Phone: 601-832-8264 | Fax: | ||||||||||||
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