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Dr. Michael Walsh Gannon, PHD,LCADC
Addiction (Substance Use Disorder) Counselor in Roseville, California
NPI 1962809699

Michael Walsh Gannon is an Addiction (Substance Use Disorder) Counselor based in Roseville, CA and is specialized in Addiction (Substance Use Disorder). Michael Walsh Gannon practices in Roseville, CA and has the professional credentials of PHD,LCADC. The NPI Number for Michael Walsh Gannon is 1962809699 and holds a License No. 1340 (California).

The current practice location address for Michael Walsh Gannon is 109 Cloud Touch Ct, Roseville, CA and can be reached out via phone at 916-318-5317.

Location: 109 Cloud Touch Ct, Roseville, CA, 95747-7116
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962809699
Provider Name
Michael Walsh Gannon
Credential
PHD,LCADC
Provider Entity Type
Individual
Gender
Male
Address
109 Cloud Touch Ct, Roseville, CA, 95747-7116
Phone Number
916-318-5317
Fax Number
Provider Enumeration Date
11/24/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
109 Cloud Touch Ct
City
Roseville
State
California
Zip
95747-7116
Phone Number
916-318-5317
Fax Number
person
Provider Business Mailing Address Details
Address
109 Cloud Touch Ct
City
Roseville
State
California
Zip
95747-7116
Phone Number
916-318-5317
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
1340 (Kentucky)
Definition
Definition to come...
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