Provider Demographics
NPI:1548737851
Name:CANELA, MARIA MERCEDES SR
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:CANELA
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7151 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08110-6124
Mailing Address - Country:US
Mailing Address - Phone:856-655-1915
Mailing Address - Fax:
Practice Address - Street 1:112 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2207
Practice Address - Country:US
Practice Address - Phone:267-798-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health