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Individual

BONNI ROCHELLE CANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2651 WHITEWAY RD APT 4, TOLEDO, OH 43606-3656
(419) 807-7263
Mailing address
2651 WHITEWAY RD APT 4, TOLEDO, OH 43606-3656
(419) 807-7263

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
179476
OH
251B00000X
Case Management Agency
179476
OH

Other

Enumeration date
01/11/2022
Last updated
01/11/2022
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