OrganizationActive
Cannon Therapeutic
NPI 1497624951 · Clinical Social Worker · Midway, UT
Provider details
- NPI number
- 1497624951
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Tucker Cannon, Owner, Provider(949) 244-9982
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
125 W Main St Unit 324
Midway, UT 84049-8014
Phone: (949) 244-9982
Approximate (ZIP-level) locationGet directions
Mailing address
125 W Main St Unit 324
Midway, UT 84049-8014
Registry dates
- Enumerated
- 2025-11-03
- Last updated
- 2025-11-03
- Certified
- 2025-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.