Individual
CARRIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
Mailing address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-111137
TN
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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