person
Mr. Yassar E Canchola, BA,LISAC
Addiction (Substance Use Disorder) Counselor in Nogales, Arizona
NPI 1871685958

Yassar E Canchola is an Addiction (Substance Use Disorder) Counselor based in Nogales, AZ and is specialized in Addiction (Substance Use Disorder). Yassar E Canchola practices in Nogales, AZ and has the professional credentials of BA,LISAC. The NPI Number for Yassar E Canchola is 1871685958 and holds a License No. LISAC11046 (Arizona).

The current practice location address for Yassar E Canchola is 32 Boulevard Del Rey David, Nogales, AZ and can be reached out via phone at 520-281-9189 and via fax at 520-281-0916. You can also correspond with Yassar E Canchola through the mailing address at 489 N ARROYO BLVD, NOGALES, AZ - 85621-2644 (mailing address contact number: 520-287-4713).

Location: 32 Boulevard Del Rey David, Nogales, AZ, 85621-2644
person
Provider Profile Details
NPI Number
1871685958
Provider Name
Yassar E Canchola
Credential
BA,LISAC
Provider Entity Type
Individual
Gender
Male
Address
32 Boulevard Del Rey David, Nogales, AZ, 85621-2644
Phone Number
520-281-9189
Fax Number
520-281-0916
Provider Enumeration Date
09/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
888563 01 AZ AHCCCS
institution
Provider Business Practice Location Address Details
Address
32 Boulevard Del Rey David
City
State
Zip
85621-9667
Phone Number
520-281-9189
Fax Number
520-281-0916
person
Provider Business Mailing Address Details
Address
32 Boulevard Del Rey David
City
State
Zip
85621-9667
Phone Number
520-281-9189
Fax Number
520-281-0916
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
LISAC11046 (Arizona)
Definition
Definition to come...
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