Individual provider · NPI-1
Jennifer Cannon, MHPS-PSS
Peer Specialist · Spring, TX
NPI number1013515238
StatusActive
Last updated in NPPESJan 4, 2022
Details
- NPI
- 1013515238
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Cannon
- Credential
- MHPS-PSS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 9, 2020
- Certification date
- Dec 30, 2021
- Last updated
- Jan 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 50025-0820 | TX | Yes |
| 171400000X | Health & Wellness Coach | – | – | |
| 172A00000X | Driver | – | – | |
| 174H00000X | Health Educator | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
1411 Wunsche Loop#2079
Spring, TX 77373-2079
Phone 832-554-6541
Mailing address
Po Box 2079Spring, TX 77383-2079
Phone 832-554-6541
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