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Individual
MR. HERMENEGILDO MARCANO
Active
Individual
MR. HERMENEGILDO MARCANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MRC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CCSS 115
PW
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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