Individual
MR. ROGER ORAZIO CANGIALOSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
960 RODEO WAY, HUALAPAI HEALTH DEPARTMENT, PEACH SPRINGS, AZ 86434
(928) 769-2216
Mailing address
2639 VALENTINE AVE, KINGMAN, AZ 86401-4713
(928) 377-3211
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C01090
MI
103T00000X
Psychologist
6301013603
MI
Other
Enumeration date
03/16/2009
Last updated
10/21/2009
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