Most Relevant Information
Provider Data
| NPI Number: | 1003640079 |
| Provider Name: | MATTHEW ROBERT CANAN CDCA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CDCA.187900 |
Most Important Dates
| Enumeration Date: | 08/30/2024 |
| Last Updated: | 08/30/2024 |
Provider Practice Location
1791 ALUM CREEK DR
COLUMBUS
OH
432071757
Practice Location Phone/Fax
| Phone: | 6144458131 |
| Fax: |
Provider Mailing Location
547 MOWRER RD
CIRCLEVILLE
OH
431131329
Provider Mailing Phone/Fax
| Phone: | 7406015769 |
| Fax: |