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Individual

MS. DOROTHY CANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5216 YOUNG DR, THE COLONY, TX 75056-1832
(469) 328-5426
Mailing address
5216 YOUNG DR, THE COLONY, TX 75056-1832
(469) 328-5426

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
TX
171WV0202X
Vehicle Modifications Contractor
TX
172A00000X
Driver
TX
172V00000X
Community Health Worker
TX
253Z00000X
In Home Supportive Care Agency
Primary
TX
347C00000X
Private Vehicle
24603614
TX

Other

Enumeration date
12/19/2008
Last updated
10/25/2013
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