| Doctor Name: | CANDACE EDWARDS |
| NPI Number: | 1205273570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 112 High Street Quest Mhsa, Llc Antlers, OK - 74523 |
| Business Phone Number: | 5805954808 |
| Business Fax Number: | |
| Mailing Address: | 1321 Sw 27th St. Apt 304, LAWTON |
| State: | OK |
| Postal Code: | 73505 |
| Phone Number: | 5802844569 |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2013 |
| NPI Last Update Date: | 05/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |