Individual
MISS CANDICE MAE VALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
2704 SADDLE ROCK RD, HOLBROOK, NY 11741-4834
(631) 827-4749
Mailing address
2704 SADDLE ROCK RD, HOLBROOK, NY 11741-4834
(631) 827-4749
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1904828
NY
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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