Most Relevant Information
Provider Data
| NPI Number: | 1003661778 |
| Provider Name: | ALEXIS CANCINO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/17/2024 |
| Last Updated: | 04/17/2024 |
Provider Practice Location
45180 CLUB DR
INDIAN WELLS
CA
922108806
Practice Location Phone/Fax
| Phone: | 7603548285 |
| Fax: |
Provider Mailing Location
45180 CLUB DR
INDIAN WELLS
CA
922108806
Provider Mailing Phone/Fax
| Phone: | 7603548285 |
| Fax: |