Individual
CANDACE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 S 4TH ST STE 200, CHICKASHA, OK 73018-4634
(405) 779-4873
Mailing address
1108 S 4TH ST STE 200, CHICKASHA, OK 73018-4634
(405) 779-4873
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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