Individual
KIMBERLY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 CARTER STREET, RICHMOND HILLS, GA 31324
(850) 862-7227
Mailing address
27 CARTER STREET, RICHMOND HILLS, GA 31324
(850) 862-7227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8320
FL
225X00000X
Occupational Therapist
OT005298
GA
Other
Enumeration date
11/13/2014
Last updated
03/21/2016
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