Individual
JACQUELINE CANILAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
141 ROUTE 70 E STE B, MARLTON, NJ 08053-1855
(856) 596-9057
(856) 596-0837
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 596-9057
(856) 596-0837
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15228900
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NR15228900
NJ
Other
Enumeration date
12/12/2024
Last updated
02/05/2025
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