Individual
MS. CLARISSA BREANNE SOURADA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC,NCC
Contact information
Practice address
820 16TH ST, GALVESTON, TX 77550-4960
(760) 504-3099
Mailing address
820 16TH ST, GALVESTON, TX 77550-4960
(760) 504-3099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
82764
TX
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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