Individual
MR. YASSAR E CANCHOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, LISAC
Contact information
Practice address
611 W UNION ST, BENSON, AZ 85602-6718
(520) 586-0800
Mailing address
611 W UNION ST, BENSON, AZ 85602-6718
(520) 586-0800
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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