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Melissa Dawn Cannon
Peer Specialist in Elizabethtown, Kentucky
NPI 1245012871

Melissa Dawn Cannon is a Peer Specialist based in Elizabethtown, KY. Melissa Dawn Cannon practices in Elizabethtown, KY. The NPI Number for Melissa Dawn Cannon is 1245012871 and holds a License No. 1212515 (Kentucky).

The current practice location address for Melissa Dawn Cannon is 308 Rosedale Dr, Elizabethtown, KY and can be reached out via phone at 270-750-8574.

Location: 308 Rosedale Dr, Elizabethtown, KY, 42701-1530
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245012871
Provider Name
Melissa Dawn Cannon
Credential
Provider Entity Type
Individual
Gender
Female
Address
308 Rosedale Dr, Elizabethtown, KY, 42701-1530
Phone Number
270-750-8574
Fax Number
Provider Enumeration Date
10/18/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
308 Rosedale Dr
City
Elizabethtown
State
Kentucky
Zip
42701-1530
Phone Number
270-750-8574
Fax Number
person
Provider Business Mailing Address Details
Address
308 Rosedale Dr
City
Elizabethtown
State
Kentucky
Zip
42701-1530
Phone Number
270-750-8574
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
1212515 (Kentucky)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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