Individual
CANDICE NICOLE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
44617 S AIRPORT RD, HAMMOND, LA 70403-0311
(985) 429-7611
Mailing address
13308 MOSS POINT DR APT A, HAMMOND, LA 70401-6448
(985) 215-1365
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/24/2019
Last updated
07/31/2019
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