MS. BRENDA GAIL CANNON BA IN PSYCHOLOGY NPI 1114490877

NPI Information

MS. Brenda Gail Cannon, BA IN PSYCHOLOGY is a residential treatment facility, intellectual and/or developmental disabilities in Raleigh, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. MS. Brenda Gail Cannon, BA IN PSYCHOLOGY NPI is 1114490877. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3105 VICO TER
RALEIGH, NC
ZIP 27610-951
Phone: (919) 637-8831
Fax: (919) 890-5578

The enumeration date for this NPI number is 1/5/2019 and was last updated on 1/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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