Individual
DYONNA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7125 GRAND MONTECITO PKWY STE 130, LAS VEGAS, NV 89149-0261
(702) 396-0101
Mailing address
3300 N TENAYA WAY APT 2109, LAS VEGAS, NV 89129-6252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
11/13/2019
Last updated
11/13/2019
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