Individual
MS. JUDITH ANN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
813-1 CHESAPEAKE DRIVE, CAMBRIDGE, MD 21613-9401
(410) 221-2266
(410) 221-2878
Mailing address
813-1 CHESAPEAKE DRIVE, CAMBRIDGE, MD 21613-9401
(410) 221-2266
(410) 221-2878
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09462
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010618101
FEDERAL TAX ID
—
05
—
479302100
—
MD
Enumeration date
09/08/2009
Last updated
09/08/2009
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