Individual
MS. CANDICE MARIE BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-3336
(704) 365-7777
(704) 365-9256
Mailing address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-3336
(704) 365-7777
(704) 365-9256
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005845
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C005845
LCSW
NC
Enumeration date
02/05/2007
Last updated
02/07/2008
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