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Individual
MR. YASSAR E CANCHOLA
Active
Individual
MR. YASSAR E CANCHOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC11046
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
888563
AHCCCS
AZ
01
—
LISAC-11046
LICENSE
AZ
Enumeration date
09/28/2006
Last updated
05/20/2025
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