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Individual

CANDICE HARRISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHLEBOTOMIST

Contact information

Practice address
316 S GUM ST, MINDEN, LA 71055-5226
(318) 505-9452
Mailing address
316 S GUM ST, MINDEN, LA 71055-5226
(318) 505-9452

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
Q5D2FT3
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10217688
N/A
LA
Enumeration date
01/09/2023
Last updated
01/09/2023
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