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Individual

MS. KANDY JOYCE PAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
105 COOKTOWN RD, WILDER, TN 38589-1729
(931) 267-1502
Mailing address
105 COOKTOWN RD, WILDER, TN 38589-1729
(931) 267-1502

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
164W00000X
Licensed Practical Nurse
61772
TN

Other

Enumeration date
05/20/2024
Last updated
05/20/2024
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