Individual
CANDICE TUDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
865 S PATTERSON BLVD, DAYTON, OH 45402-2624
(937) 966-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 743-7628
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.187019
OH
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
APS.003541
OH
Other
Enumeration date
10/12/2022
Last updated
05/15/2024
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