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Individual

CANDICE R NERVEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 683-1062
Mailing address
17 PONI MOI PL, HILO, HI 96720-1739

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11939539
106S00000X
Behavior Technician

Other

Enumeration date
10/24/2017
Last updated
12/26/2019
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