Individual
CHELSEA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 W STATE HWY 6, WACO, TX 76712
(254) 644-5200
Mailing address
330 W STATE HWY 6, WACO, TX 76712
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224Z00000X
TAXONOMY
TX
Enumeration date
10/17/2018
Last updated
10/17/2018
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