Individual
CANDACE ELEASE THOMAS HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 E CUNNINGHAM ST SS, TERRY, MS 39170
(601) 983-7168
(769) 257-5659
Mailing address
PO BOX 515, TERRY, MS 39170-0515
(601) 983-7168
(769) 251-1295
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
385H00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00503597
—
MS
Enumeration date
05/09/2014
Last updated
11/08/2023
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