Courtney Leigh Cannon, BHRS

NPI #1174819759 in Idabel, Oklahoma

Provider Information

NPI Number: 1174819759
Entity Type: Individual
Name: Courtney Leigh Cannon, BHRS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: BHRS
Enumeration Date: Jun 22, 2011
Last Updated: Jun 22, 2011

Practice Location

Address: 1407 SE MONROE ST
City: Idabel
State: Oklahoma
ZIP Code: 74745-6619
Phone: (580) 612-8045

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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