# CANNON SPEECH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CANNON SPEECH SERVICES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063095602
- **Legal business name:** CANNON SPEECH SERVICES LLC
- **Authorized official:** STACEY CANNON M.S. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (830) 315-6400

## Contact information

- **Practice address:** 327 EARL GARRETT ST STE 108, KERRVILLE, TX 78028-4500
- **Practice address phone:** (830) 315-6400
- **Mailing address:** PO BOX 643, INGRAM, TX 78025-0643
- **Mailing address phone:** (214) 354-5201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | NULL | Yes |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2021
- **Last updated:** 05/02/2021