Individual
KENSHAWNA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2815 E 130TH ST APT 606A, CLEVELAND, OH 44120-5905
(216) 854-1801
Mailing address
2815 E 130TH ST APT 606A, CLEVELAND, OH 44120-5905
(216) 854-1801
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UE645190
—
OH
Enumeration date
11/17/2021
Last updated
11/17/2021
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