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Individual

ANGELICA CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
755 ELECTRIC DR, SUMTER, SC 29153-1933
(803) 905-5100
Mailing address
1106 CHIVALRY ST, SUMTER, SC 29154-7412

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/14/2023
Last updated
06/14/2023
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