Individual
MS. BETTY KAY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10910 LISTI DR, DALLAS, TX 75238-2952
(214) 537-9297
(214) 343-3321
Mailing address
PO BOX 740152, DALLAS, TX 75374-0152
(214) 537-9297
(214) 343-3321
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
16220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NS162122
ID VALUE OPTIONS
TX
Enumeration date
01/16/2007
Last updated
07/09/2007
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