| Cannon Psychological Llc | |
|
12058 San Jose Blvd Ste 202 Jacksonville FL 32223-8669 | |
| (043) 738-2999 | |
| Not Available |
| Full Name | Cannon Psychological Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 12058 San Jose Blvd Ste 202, Jacksonville, Florida |
| Authorized Official Name and Position | Brittany Cannon (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 3523396751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannon Psychological Llc 3075 Orange Picker Rd Jacksonville FL 32223-0882 Ph: (352) 339-6751 | Cannon Psychological Llc 12058 San Jose Blvd Ste 202 Jacksonville FL 32223-8669 Ph: (043) 738-2999 |
| NPI Number | 1134976061 |
|---|---|
| Provider Enumeration Date | 04/30/2024 |
| Last Update Date | 05/01/2024 |
| Certification Date | 05/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134976061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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