Fanta Fantey Cannon, BCBA
Individual provider Active NPI Behavior Analyst · Poland, OH
NPI 1275175341 · NPPES record last updated Jan 23, 2024
Key facts
- NPI
- 1275175341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 1051 Tiffany S
Poland, OH 44514-1977 - Phone
- (330) 629-2955
- NPI assigned
- Oct 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knapp Center for Childhood Development | Current |
Accepting new patients | |
| Absolute Behavior Health Care LLC | Current |
Accepting new patients |
Locations
950 Windham Ct
Ste 4
Boardman, OH 44512
Phone (330) 502-0817
7423 Tiffany S
Youngstown, OH 44514
Phone (330) 629-2955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | Yes |
Addresses
Primary practice location
1051 Tiffany S
Poland, OH 44514-1977
Mailing address
1051 Tiffany S
Poland, OH 44514-1977
Phone (330) 629-2955
Other providers in Poland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.