Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TUCKER CROXALL CANNON, LCSW
Active Sole ProprietorMR. TUCKER CROXALL CANNON, LCSW is a School Social Worker healthcare provider located in ALTADENA, California. NPI 1205969623 is currently active in the NPPES registry. Verify at CMS.
School Social Worker · ALTADENA, CA
Registration Details
- NPI Number
- 1205969623
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 14, 2007 (19.238105346798 yrs)
- Last Updated
- Nov 2, 2012
- Licenses
-
28707 (CA)18784 (CA)28707 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2046 ALLEN AVE RM 100ALTADENA, CA, 910013424Browse CA providers · Browse ZIP 91001
- Phone
- 6266609419
- Primary Specialty
-
School Social Worker
1041S0200X
- Additional Specialty
- School Social Worker
- Additional Specialty
- School Social Worker
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.