Canavan, Alycia

Canavan, Alycia is an individual health care provider with primary practice located at 1126 Gateway Loop Ste 112 , Springfield OR 97477-7723. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Canavan, Alycia can be contacted via phone (541) 371-2782.

Contact Information

Primary practice address
1126 Gateway Loop Ste 112 Springfield OR 97477-7723
Phone: (541) 371-2782
Fax: (541) 804-7695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 15420 Oregon

Profile Details

NPI number 1760864078
LBN Legal business name Canavan, Alycia
Credentials M.A., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2015
Last updated Oct 2nd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760864078 NPPES
Oregon MEDICAID 500689312

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