Individual
DANIELLE ELAINE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
950 W IRONWOOD DR STE 6, COEUR D ALENE, ID 83814-2644
(208) 661-2645
Mailing address
14615 REAGAN CT, RATHDRUM, ID 83858-8327
(208) 661-2645
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-31545
ID
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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