Individual
CANDACE JANIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., FABORM
Contact information
Practice address
14 CHURCH STREET, BASKING RIDGE, NJ 07920
(908) 719-1362
Mailing address
PO BOX 200, LIBERTY CORNER, NJ 07938-0200
(908) 719-1362
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00044200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-5203194
TAX ID #
NJ
Enumeration date
01/25/2007
Last updated
04/15/2019
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