Individual
AMANDA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 AUDUBON RD STE 1, WAKEFIELD, MA 01880-1266
(617) 284-4985
Mailing address
107 AUDUBON RD STE 1, WAKEFIELD, MA 01880-1266
(617) 284-4985
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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