Individual
DR. CANDACE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
205 SWEET MAPLE DR, RICHMOND, KY 40475-8045
(931) 629-6013
Mailing address
205 SWEET MAPLE DR, RICHMOND, KY 40475-8045
(931) 629-6013
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
262239
KY
101YP2500X
Professional Counselor
3471
AL
101YP2500X
Professional Counselor
4323
LA
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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