Cannon, Jennifer

Cannon, Jennifer is an sole proprietor health care provider with primary practice located at 1411 Wunsche Loop #2079, Spring TX 77373-2079. She recently has 4 registered licenses in different health care specialties including Other Service Providers / Driver, Other Service Providers / Health Educator, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Cannon, Jennifer can be contacted via phone (832) 554-6541.

Contact Information

Primary practice address
1411 Wunsche Loop #2079 Spring TX 77373-2079
Phone: (832) 554-6541
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X
Other Service Providers / Health Educator 174H00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Other Service Providers / Peer Specialist 175T00000X 50025-0820 Texas

Profile Details

NPI number 1013515238
LBN Legal business name Cannon, Jennifer
Credentials MHPS-PSS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 9th, 2020
Last updated Jan 4th, 2022 - about 3 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 1013515238 NPPES
Texas MEDICAID D18305791
Texas Other 50025-0821

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