Cannon, Jean S

Cannon, Jean S is an sole proprietor health care provider with primary practice located at 1681 Crown Ave Suite 11, Lancaster PA 17601-6303. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Cannon, Jean S can be contacted via phone (717) 393-9388.

Contact Information

Primary practice address
1681 Crown Ave Suite 11 Lancaster PA 17601-6303
Phone: (717) 393-9388
Fax: (717) 393-9389
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS015850 Pennsylvania

Profile Details

NPI number 1104874445
LBN Legal business name Cannon, Jean S
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2006
Last updated Mar 17th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104874445 NPPES
Pennsylvania MEDICAID 101535870-0001
Pennsylvania Other CA1850139

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