Individual
THOMAS A. CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC3836
ME
Other
Enumeration date
09/25/2009
Last updated
04/20/2015
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