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1760105381
KHADIJAH CANNON
GREENVILLE, SC
NPI
1760105381
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: SC RBT-22-232197)
Enumeration Date
2022-09-20
Last Update Date
2022-09-20
Business Address
KHADIJAH CANNON
18 MEMORIAL MEDICAL DR
GREENVILLE, SC 29605-4452
Phone number: 706-842-5330
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Mailing Address
KHADIJAH CANNON
525 8TH ST P.O. BOX 2567
AUGUSTA, GA 30901-9998
Phone number: 706-842-5330
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