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General NPI Number Information
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NPI Number | 1972390896
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Entity Type | Individual
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Provider Name | GINGER MOORE CANNON
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 424 ESTHER CT
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City | FORT MILL
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State | SC
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Zip | 29708-5707
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Country | US
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Telephone | 201-906-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 438 GUILFORD RD
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City | ROCK HILL
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State | SC
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Zip | 29732-1940
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Country | US
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Telephone | 843-312-0670
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 244053
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9048
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License Number State | SC
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