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HORTENCIA L CANNON

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1457980435

Individual Registrant:
 HORTENCIA L CANNON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
202 W BADGER AVE  EUSTIS, FL 32726-4505 US
Tel: 352-602-8883  Fax: --

Contact information for business:
202 W BADGER AVE  EUSTIS, FL 32726-4505 US
Tel: 352-602-8883  Fax: --

Registration Information:
NPI: 1457980435
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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