Provider Demographics
NPI:1942471081
Name:CANO, SONIA (MA, LAC)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:
Last Name:CANO
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8568 W SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-4145
Mailing Address - Country:US
Mailing Address - Phone:623-412-9182
Mailing Address - Fax:
Practice Address - Street 1:4444 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1683
Practice Address - Country:US
Practice Address - Phone:623-939-6516
Practice Address - Fax:623-939-0370
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12660101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health