Doctor Name: | MS. CANDACE P REED |
NPI Number: | 1083756209 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA, MHPP |
License Number: | |
Business Practice Address: | 2500 Rike Dr Pine Bluff, AR - 716033937 |
Business Phone Number: | 8705365639 |
Business Fax Number: | 8705345798 |
Mailing Address: | 2500 Rike Dr, PINE BLUFF |
State: | AR |
Postal Code: | 716033937 |
Phone Number: | 8705365639 |
Fax Number: | 8705345798 |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |