Individual
CANDIDA DEVIVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
853 DURHAM RD STE H, WAKE FOREST, NC 27587-8793
(919) 556-1092
Mailing address
50 STONECREST DR, LOUISBURG, NC 27549-6471
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14886
NC
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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