Individual
CANDACE STAUFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298-1059
(618) 939-4444
Mailing address
988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298-1059
(618) 939-4444
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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