Individual
DONNA MICHELLE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25321 LINDA VISTA DR, LAGUNA HILLS, CA 92653-5310
(562) 244-0504
Mailing address
25321 LINDA VISTA DR, LAGUNA HILLS, CA 92653-5310
(562) 244-0504
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CA
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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