Individual
ALEXIS CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2513 W 2ND ST, MARION, IN 46952-3241
(765) 662-0490
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-248008
IN
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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