Individual
CANDICE NYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7214 PLANK RD, LOCKPORT, NY 14094-9352
(716) 531-3203
Mailing address
7214 PLANK RD, LOCKPORT, NY 14094-9352
(716) 531-3203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002989
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002989
LICENSE #
NY
Enumeration date
03/18/2016
Last updated
03/18/2016
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