STACEY CANNON

LONG BEACH, CA
NPI1013217132
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2010-10-22
Last Update Date2010-10-22
Business Address
-- STACEY CANNON
2008 PACIFIC AVE
LONG BEACH, CA 90806-4610
Phone number: 562-591-0011
Mailing Address
-- STACEY CANNON
2008 PACIFIC AVE
LONG BEACH, CA 90806-4610
Phone number: 562-591-0011
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