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Requisha Champagne Cannon
Mental Health Counselor in Watertown, New York
NPI 1184482911

Requisha Champagne Cannon is a Mental Health Counselor based in Watertown, NY and is specialized in Mental Health. Requisha Champagne Cannon practices in Watertown, NY. The NPI Number for Requisha Champagne Cannon is 1184482911 and holds a License No. (New York).

The current practice location address for Requisha Champagne Cannon is 250 Arsenal St Ste 2, Watertown, NY and can be reached out via phone at 315-782-9030.

Location: 250 Arsenal St Ste 2, Watertown, NY, 13601-3102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184482911
Provider Name
Requisha Champagne Cannon
Credential
Provider Entity Type
Individual
Gender
Female
Address
250 Arsenal St Ste 2, Watertown, NY, 13601-3102
Phone Number
315-782-9030
Fax Number
Provider Enumeration Date
03/07/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
250 Arsenal St Ste 2
City
Watertown
State
New York
Zip
13601-2589
Phone Number
315-782-9030
Fax Number
person
Provider Business Mailing Address Details
Address
250 Arsenal St Ste 2
City
Watertown
State
New York
Zip
13601-2589
Phone Number
315-782-9030
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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