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Individual
EMILY ANNE VAN CANNON
Active
Individual
EMILY ANNE VAN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC4077
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC4548
ME
101YM0800X
Mental Health Counselor
Primary
XL4264
ME
104100000X
Social Worker
LSX11430
ME
Other
Enumeration date
12/03/2008
Last updated
02/13/2015
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