Provider Demographics
NPI:1659618981
Name:CANELA, NANCY LIZET
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LIZET
Last Name:CANELA
Suffix:
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 1:4124 PENNWOOD AVE
Mailing Address - Street 2:APT A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7615
Mailing Address - Country:US
Mailing Address - Phone:702-418-5922
Mailing Address - Fax:
Practice Address - Street 1:4124 PENNWOOD AVE
Practice Address - Street 2:APT A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7615
Practice Address - Country:US
Practice Address - Phone:702-418-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst