Individual
MRS. RENEE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Contact information
Practice address
36975 UTICA RD, SUITE 104, CLINTON TOWNSHIP, MI 48036-1685
(586) 226-3440
(586) 226-3740
Mailing address
1279 MULBERRY ST, MOUNT CLEMENS, MI 48043-3003
(586) 469-9609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401007746
MI
Other
Enumeration date
11/10/2006
Last updated
06/10/2009
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