Individual
NICOLETTE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3325 POCAHONTAS RD, BAKER CITY, OR 97814-1464
(541) 524-7720
Mailing address
3325 POCAHONTAS RD, BAKER CITY, OR 97814-1464
(541) 524-7720
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17387
OR
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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