Individual
CANDACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4410 EXECUTIVE BLVD, FORT WAYNE, IN 46808-1135
(888) 515-1793
Mailing address
8413 SPYGLASS DR, INDIANAPOLIS, IN 46260-1937
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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