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Individual
TINA M FANELLO
Active
Individual
TINA M FANELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.00001120
CO
1041C0700X
Clinical Social Worker
LCS 29167
CA
Other
Enumeration date
01/29/2014
Last updated
10/12/2018
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