Individual
CANDACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0935
(602) 933-0610
Mailing address
1919 E THOMAS RD BLDG 2108, STE 101, PHOENIX, AZ 85016-7710
(602) 512-8029
(602) 512-8161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1105086
AZ
Other
Enumeration date
11/20/2014
Last updated
11/29/2023
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