Organization
CANNON CONSULTING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON EDWARD CANNON (BUSINESS MANAGER)
(772) 206-0334
Entity
Organization
Contact information
Practice address
758 NW RAINBOW ST, PORT ST LUCIE, FL 34983-8309
(772) 206-0334
Mailing address
758 NW RAINBOW ST, PORT ST LUCIE, FL 34983-8309
(772) 206-0334
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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