Individual
PHILANA CICOLELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
656 BELMONT WAY, CHINO VALLEY, AZ 86323-5795
(310) 256-0491
Mailing address
656 BELMONT WAY, CHINO VALLEY, AZ 86323-5795
(310) 256-0491
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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