| NPI | 1114389301 |
|---|---|
| Former Name | CANDACE LYNN BUCKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801099467) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-03445) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2024-03-21 |