Provider Demographics
NPI:1902027857
Name:LIMCANGCO, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:LIMCANGCO
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 1:117 W AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-5787
Mailing Address - Country:US
Mailing Address - Phone:985-641-8814
Mailing Address - Fax:
Practice Address - Street 1:117 W AUGUSTA LN
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5787
Practice Address - Country:US
Practice Address - Phone:985-641-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01162F171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor