Individual
MR. ANTHONY WAYNE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1724 ROXIE AVE, FAYETTEVILLE, NC 28304-1623
(910) 222-6003
Mailing address
2406 KIMBERLY DR, FAYETTEVILLE, NC 28306-2345
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1785
NC
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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