Individual provider · Type 1 NPI
Brenda Gail Cannon, BA IN PSYCHOLOGY
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Raleigh, NC
Practice location
3105 Vico Ter
Raleigh, NC 27610-5951
Fax (919) 890-5578
Mailing address
1301 Southgate Dr
Raleigh, NC 27610-5090
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | None listed |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | MHL-092-898 (NC) |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Other intellectual and/or developmental disabilities residential treatment facility providers in Raleigh
- Henrietta JohnsonIntellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC NPI 1245121896
- Lilian Ananaba, 4023 WAKE FOREST ROIntellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC NPI 1265393821
- Dorothy C. Umeh, BS, MBAIntellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC NPI 1699956417
- Lilian NgangaIntellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC NPI 1891668554
About NPI 1114490877
Brenda Gail Cannon, BA IN PSYCHOLOGY's National Provider Identifier is 1114490877, issued on Jan 5, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Raleigh, NC. The record was last updated on Jan 5, 2019.