Individual
CANDICE JARVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
615 BROADWAY APT 31, AMITYVILLE, NY 11701-2140
(631) 532-5453
Mailing address
615 BROADWAY APT 31, AMITYVILLE, NY 11701-2140
(631) 532-5453
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R055452-1
NY
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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