Individual
RONNIQUA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3555 SUNSET OFFICE DR, SAINT LOUIS, MO 63127-1015
(314) 377-5968
Mailing address
5207 LAKEWOOD TER APT 205, IMPERIAL, MO 63052-4044
(314) 405-0280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-318947
MO
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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