Individual
LORI ALTHEA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18519 AUTUMN LN, SOUTHFIELD, MI 48076-1048
(313) 613-5067
Mailing address
18519 AUTUMN LN, SOUTHFIELD, MI 48076-1048
(313) 613-5067
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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