Provider Demographics
NPI:1023991957
Name:MYERS, CANISHA DANYALE (PTA)
Entity type:Individual
Prefix:
First Name:CANISHA
Middle Name:DANYALE
Last Name:MYERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 WEDDEL STREET
Mailing Address - Street 2:CANISHA.MYERS@GMAIL.COM
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180
Mailing Address - Country:US
Mailing Address - Phone:313-413-4662
Mailing Address - Fax:
Practice Address - Street 1:7220 WEDDEL STREET
Practice Address - Street 2:CANISHA.MYERS@GMAIL.COM
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:313-413-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502008624225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant