Individual
CANDICE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 S PHILLIPS ST, LAKE WALES, FL 33853-4449
(863) 280-1574
Mailing address
51 S PHILLIPS ST, LAKE WALES, FL 33853-4449
(863) 280-1574
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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