Individual
CALLEEN ANN CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
845 W CENTER ST, POCATELLO, ID 83204-4205
(208) 295-9430
(208) 213-5765
Mailing address
845 W CENTER ST, POCATELLO, ID 83204-4205
(208) 295-9430
(208) 213-5765
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-4273
ID
Other
Enumeration date
06/28/2007
Last updated
03/04/2025
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