Individual
CANDACE IANNUZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1835 GILMORE AVE, LAKELAND, FL 33805
(863) 519-0575
Mailing address
160 E HOOKER ST, BARTOW, FL 33830-5617
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH16120
FL
101YP2500X
Professional Counselor
MH16120
FL
Other
Enumeration date
07/10/2018
Last updated
07/31/2018
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