Cannon, Mary Dale

Cannon, Mary Dale is an sole proprietor health care provider with primary practice located at 2775 Executive Park Nw Suite 1, Cleveland TN 37312-2763. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Cannon, Mary Dale can be contacted via phone (423) 479-9652.

Contact Information

Primary practice address
2775 Executive Park Nw Suite 1 Cleveland TN 37312-2763
Phone: (423) 479-9652
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X P2889 Tennessee
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2889 Tennessee

Profile Details

NPI number 1477883668
LBN Legal business name Cannon, Mary Dale
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2010
Last updated Oct 30th, 2017 - about 7 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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