Individual
JESSIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 CHURCH ST, LACONIA, NH 03246-3432
(603) 524-1100
Mailing address
111 CHURCH ST, LACONIA, NH 03246-3432
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0902
NH
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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