Individual
MISS CANDI RENAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
87 TWIN OAK PL, MC KEE, KY 40447-7190
(606) 493-6176
Mailing address
87 TWIN OAK PL, MC KEE, KY 40447-7190
(606) 493-6176
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
201153621
KY
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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