Individual
CANDACE NICOLE PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 S DIXON RD, KOKOMO, IN 46902-2997
(765) 469-1928
Mailing address
51 LOGAN ST, PERU, IN 46970-1642
(765) 469-1928
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-496124
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-25-496124
BACB
IN
Enumeration date
12/04/2025
Last updated
12/04/2025
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