Organization
NEDRA CANNON LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEDRA CANNON (OWNER)
(517) 219-5761
Entity
Organization
Contact information
Practice address
411 W LAKE LANSING RD STE C120, EAST LANSING, MI 48823-8483
(517) 219-5761
Mailing address
PO BOX 26162, LANSING, MI 48909-6162
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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