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General NPI Number Information
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NPI Number | 1881880664
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Entity Type | Individual
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Provider Name | CAMERON FREEMAN CANNON PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 3031 W 76TH AVE
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City | WESTMINSTER
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State | CO
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Zip | 80030-4909
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Country | US
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Telephone | 303-853-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 8931 HURON ST
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City | THORNTON
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State | CO
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Zip | 80260-6806
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Country | US
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Telephone | 303-853-3846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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