Individual
MARY E GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA PCC
Contact information
Practice address
2020 W SCHAAF RD, CLEVELAND, OH 44109-4608
(614) 706-7554
Mailing address
918 E SCHAAF RD, BROOKLYN HEIGHTS, OH 44131-1224
(216) 543-4359
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.0900421
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
01
—
822511633
TAX ID
OH
Enumeration date
02/01/2013
Last updated
01/14/2022
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