Individual
NATIVIDAD CANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGS, LISAC
Contact information
Practice address
1701 N DOUGLAS AVE, DOUGLAS, AZ 85607-1019
(520) 364-1286
(520) 805-1221
Mailing address
489 N ARROYO BLVD, NOGALES, AZ 85621-2644
(520) 287-4713
(520) 287-9794
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC 1128
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
922874
AZ AHCCCS
AZ
Enumeration date
10/17/2006
Last updated
07/08/2007
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