Individual
SHELLEY CANNON FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2496 RICKER ROAD, EL PASO, TX 79916
(915) 742-9558
(915) 742-2363
Mailing address
2496 RICKER ROAD, EL PASO, TX 79916
(915) 742-9558
(915) 742-2363
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
17-043
NC
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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