Individual
CANDACE BRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 CHAMPION LAKE BLVD, APT 401, SHREVEPORT, LA 71105-3772
(318) 655-7449
Mailing address
3501 CHAMPION LAKE BLVD, APT 401, SHREVEPORT, LA 71105-3772
(318) 655-7449
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/02/2017
Last updated
01/02/2017
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