Individual
DR. CANDIS MIAH CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
13515 LAKE TERRACE LN, TAMPA, FL 33637-1003
(813) 919-9152
Mailing address
13515 LAKE TERRACE LN, TAMPA, FL 33637-1003
(813) 919-9152
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810005647
VA
Other
Enumeration date
05/24/2017
Last updated
02/02/2022
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