Individual
JENNA R CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
138 TOMAHAWK DR, ELSBERRY, MO 63343-1151
(573) 898-5554
Mailing address
56 STRAIGHT ST, ELSBERRY, MO 63343-3503
(636) 578-7352
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
08/01/2025
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