Individual
ANNETTE MICHELLE GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6200 ROCKSIDE WOODS BLVD N, INDEPENDENCE, OH 44131-2333
(215) 525-1885
Mailing address
2218 ALGER RD, LAKEWOOD, OH 44107-5805
(216) 645-6214
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/18/2018
Last updated
02/04/2019
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