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NPI Profile for FRED R CANNON III in FLORENCE, SC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Pastoral |
101YP1600X |
| NPI Number | 1295961019 |
|
| Status | Active | |
| Credentials | M.A., LPC, BCPCC | |
| Entity | Individual | |
| Enumeration date | 06/08/2009 | |
| Last updated | 06/08/2009 - About 17 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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FRED R CANNON III
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FRED R CANNON III, M.A., LPC, BCPCC