Individual
MR. FRED REEVES CANNON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LPC, BCPCC
Contact information
Practice address
1140 3RD LOOP RD, FLORENCE, SC 29505-3709
(843) 662-2021
(843) 662-2021
Mailing address
1140 3RD LOOP RD, FLORENCE, SC 29505-3709
(843) 662-2021
(843) 662-2021
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
5016
SC
101YP2500X
Professional Counselor
Primary
5016
SC
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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