Individual
KAYLA D CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7310 WOODWARD AVE STE 600, DETROIT, MI 48202-3165
(313) 896-1444
Mailing address
18460 KELLY RD, DETROIT, MI 48224-1024
(313) 736-8188
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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