Individual
KIRSTEN CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC-MHSP, NCC
Contact information
Practice address
895 S COOPER ST STE 123AND6, MEMPHIS, TN 38104-5604
(901) 498-9126
Mailing address
895 S COOPER ST STE 123AND6, MEMPHIS, TN 38104-5604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4755
TN
101YP2500X
Professional Counselor
Primary
4755
TN
101YS0200X
School Counselor
000714487
TN
Other
Enumeration date
10/11/2019
Last updated
11/14/2019
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