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Renetta Dawn Cannon, LSAA
Addiction (Substance Use Disorder) Counselor in Albuquerque, New Mexico
NPI 1750615134

Renetta Dawn Cannon is an Addiction (Substance Use Disorder) Counselor based in Albuquerque, NM and is specialized in Addiction (Substance Use Disorder). Renetta Dawn Cannon practices in Albuquerque, NM and has the professional credentials of LSAA. The NPI Number for Renetta Dawn Cannon is 1750615134 and holds a License No. 0084181 (New Mexico).

The current practice location address for Renetta Dawn Cannon is 600 1St St Nw Ste 200, Albuquerque, NM and can be reached out via phone at 505-224-9124 and via fax at 505-247-9503. You can also correspond with Renetta Dawn Cannon through the mailing address at 600 1ST ST NW STE 200, ALBUQUERQUE, NM - 87102-2311 (mailing address contact number: 505-224-9124).

Location: 600 1St St Nw Ste 200, Albuquerque, NM, 87102-2311
person
Provider Profile Details
NPI Number
1750615134
Provider Name
Renetta Dawn Cannon
Credential
LSAA
Provider Entity Type
Individual
Gender
Female
Address
600 1St St Nw Ste 200, Albuquerque, NM, 87102-2311
Phone Number
505-224-9124
Fax Number
505-247-9503
Provider Enumeration Date
10/01/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
71750274 05 NM
institution
Provider Business Practice Location Address Details
Address
600 1St St Nw Ste 200
City
State
Zip
87102-2311
Phone Number
505-224-9124
Fax Number
505-247-9503
person
Provider Business Mailing Address Details
Address
600 1St St Nw Ste 200
City
State
Zip
87102-2311
Phone Number
505-224-9124
Fax Number
505-247-9503
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0084181 (New Mexico)
Definition
Definition to come...
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