| NPI | 1235900754 |
|---|---|
| Former Name | CANDACE CRYSDALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW20190) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW20190) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-01-23 |