Organization
OPTVIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE ANN JAMES PMHNP-BC (OWNER)
(435) 553-5915
Entity
Organization
Contact information
Practice address
1034 RSI DR UNIT 120, LOGAN, UT 84321-2203
(435) 704-9342
(435) 355-3874
Mailing address
98 E 500 S, PROVIDENCE, UT 84332-9801
(435) 553-5915
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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