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HORTENCIA L CANNON
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1457980435
Individual Registrant: HORTENCIA L CANNON
Gender: F
Not Sole Proprietor
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: --
Tel: 352-602-8883 Fax: --
Contact information for business:
202 W BADGER AVE EUSTIS, FL 32726-4505 US
Tel: 352-602-8883 Fax: --
Tel: 352-602-8883 Fax: --
Registration Information:
NPI: 1457980435
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
