Provider Information for 1346346525
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Ms. DOLORES ERIKA CANCINO LCSW-BACS
Other Names:Former Name:Ms. DOLORES CANCINO CLEMONS LCSW-BACSSex: Female
NPI: 1346346525
Last Updated: 2024-08-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1346346525 | ||||||||||||
| Enumeration Date | 2006-09-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 5213 JERRAL DRIVE PRINCE GEORGE, VA 23875 United States Phone: 307-240-0879 | Fax: | ||||||||||||
| Primary Practice Address | 5213 JERRAL DRIVE PRINCE GEORGE, VA 23875 United States Phone: 307-240-0879 | Fax: | ||||||||||||
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