Individual
CANDICE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16067 M. L. K. DR., TCHULA, MS 39169-0518
(662) 299-3264
Mailing address
PO BOX 518, TCHULA, MS 39169-0518
(662) 299-3264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7516
MS
Other
Enumeration date
11/17/2007
Last updated
01/03/2014
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