Individual
DEVAUNIER CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3090 OUTLET PKWY APT 317, GRAND PRAIRIE, TX 75052-7258
(254) 630-0734
Mailing address
3090 OUTLET PKWY APT 317, GRAND PRAIRIE, TX 75052-7258
(254) 630-0734
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
63841
TX
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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