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NPI Code Detail

MEDICARE: SHAMARIYA CANNON

MEDICARE: SHAMARIYA CANNON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1881428605
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMARIYA CANNON
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY STE 30
Second Line :
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 989-401-2244
Fax Number :
Provider Business Practice Location Address
First Line : 6200 STATE ST
Second Line :
City : SAGINAW
State : MI
Zip : 48603-3490
Country : US
Telephone Number : 989-475-5489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2024
Last Update Date : 08/26/2024

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Directions to “ SHAMARIYA CANNON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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