Individual
CANDACE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2840 HENDERSON DR, JACKSONVILLE, NC 28546-5242
(910) 378-2501
Mailing address
2840 HENDERSON DR, JACKSONVILLE, NC 28546-5242
(910) 378-2501
(910) 939-1490
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-61899
—
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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