Individual
KANDISS SHANELL MCLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 BAINBRIDGE BLVD, NORFOLK, VA 23523-1309
(757) 339-0744
Mailing address
1102 BAINBRIDGE BLVD, NORFOLK, VA 23523-1309
(757) 339-0744
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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