Individual
HOLLY CANNON
Active
Individual
HOLLY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P3401
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323821403
—
TX
01
—
8EC651
BCBS
TX
Enumeration date
11/03/2009
Last updated
05/14/2020
Update your record
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