Individual
CANDACE LEA DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
555 SPRING HILL RD, POPLARVILLE, MS 39470-8742
(601) 408-0691
Mailing address
555 SPRING HILL RD, POPLARVILLE, MS 39470-8742
(601) 408-0691
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA.200205
LA
224Z00000X
Occupational Therapy Assistant
Primary
TA2355
MS
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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