Individual
MR. JAMES KENNEDY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW-S, LICDC-CS
Contact information
Practice address
310 TROY ST, DAYTON, OH 45404-1858
(937) 463-2955
(937) 531-7019
Mailing address
310 TROY ST, DAYTON, OH 45404-1858
(937) 463-2955
(937) 531-7019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
913109
OH
1041C0700X
Clinical Social Worker
Primary
I 1000338
OH
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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