Individual
ALICIA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1534
(443) 923-4442
(443) 923-4403
Mailing address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1534
(443) 923-4442
(443) 923-4403
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
05106
MD
103G00000X
Clinical Neuropsychologist
0810004365
VA
103TC0700X
Clinical Psychologist
05106
MD
103TC0700X
Clinical Psychologist
0810004365
VA
Other
Enumeration date
03/30/2011
Last updated
12/28/2023
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