Individual
MRS. AMY ALICIA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1099 N MERIDIAN ST, STE. 900, INDIANAPOLIS, IN 46204-1075
(317) 988-1423
(317) 988-5524
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-1423
(317) 988-5524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34007059A
IN
Other
Enumeration date
12/12/2006
Last updated
09/19/2014
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