Ebony Cannon
Individual provider Active NPI Behavior Technician · St.Louis, MO
NPI 1992291660 · NPPES record last updated Jul 6, 2018
Key facts
- NPI
- 1992291660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 7700 Minosotta Ave
St.Louis, MO 63111 - Phone
- (314) 449-1497
- NPI assigned
- Jul 6, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
7700 Minosotta Ave
St.Louis, MO 63111
Mailing address
1430 Olive St Ste 400
Saint Louis, MO 63103-2303
Phone (314) 206-3700
Other providers in St.Louis, MO
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- Rickie Lorenzo Bratton Jr.
- Jamuna Chalasani
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All providers in St.Louis, MO · Behavior Technician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2018. 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.