Provider Demographics
NPI:1528155827
Name:CANNON, MARYANNA RUTH
Entity type:Individual
Prefix:MS
First Name:MARYANNA
Middle Name:RUTH
Last Name:CANNON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARYANNA
Other - Middle Name:RUTH
Other - Last Name:SOKOL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10440 DEERWOOD RD
Mailing Address - Street 2:APT. 1233
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1135
Mailing Address - Country:US
Mailing Address - Phone:713-782-5729
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist