Individual provider · Type 1 NPI
Tucker Croxall Cannon, LCSW
School Social Worker · Altadena, CA
NPI number
1205969623
Active
Practice location
2046 Allen Ave Rm 100
Altadena, CA 91001-3424
Mailing address
204 Main St. Suite 4091
Newport Beach, CA 92661-9998
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | 28707 (CA) |
| School Social Worker | 1041S0200X | 18784 (CA) |
| School Social Worker Primary | 1041S0200X | 28707 (CA) |
School Social Worker: Definition to come...
2 other providers at this address
About NPI 1205969623
Tucker Croxall Cannon, LCSW's National Provider Identifier is 1205969623, issued on Mar 14, 2007. The primary taxonomy on file is School Social Worker (1041S0200X), and the practice location is in Altadena, CA. The record was last updated on Nov 2, 2012.