Most Relevant Information
Provider Data
| NPI Number: | 1003420639 |
| Provider Name: | STACIE CANNELL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/01/2020 |
| Last Updated: | 09/21/2022 |
Provider Practice Location
5151 MONROE ST STE 232
TOLEDO
OH
436233461
Practice Location Phone/Fax
| Phone: | 4195749290 |
| Fax: | 2487124381 |
Provider Mailing Location
5151 MONROE ST STE 232
TOLEDO
OH
436233461
Provider Mailing Phone/Fax
| Phone: | 4195749290 |
| Fax: | 2487124381 |