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1700546488
CHARLES E CANCILLA
SUWANEE, GA
NPI
1700546488
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: GA 4473)
Enumeration Date
2021-12-22
Last Update Date
2021-12-22
Business Address
Dr. CHARLES E CANCILLA Ph.D.
897 EVA KENNEDY RD
SUWANEE, GA 30024-1911
Phone number: 404-400-2547
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Mailing Address
Dr. CHARLES E CANCILLA Ph.D.
2345 DUNCANS SHORE DR
BUFORD, GA 30519-6222
Phone number: 404-218-0180
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