Individual
CANDACE LONGO
Active
Individual
CANDACE LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5648
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5648
LICENSE
TN
Enumeration date
06/12/2017
Last updated
02/16/2023
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