Cannon, Lisa Claire

Cannon, Lisa Claire is an individual health care provider with primary practice located at 1600 Sutter Pl , Clovis NM 88101-4611. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Cannon, Lisa Claire can be contacted via phone (505) 769-4490.

Contact Information

Primary practice address
1600 Sutter Pl Clovis NM 88101-4611
Phone: (505) 769-4490
Fax: (505) 935-0011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 2459 New Mexico

Profile Details

NPI number 1801965959
LBN Legal business name Cannon, Lisa Claire
Credentials MS CCC A
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Jul 8th, 2007 - about 17 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 1801965959 NPPES
New Mexico MEDICAID 000Z7838

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