Healthcare Provider Details

I. General information

NPI: 1386561926
Provider Name (Legal Business Name): CANDACE MARIE BRITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4931 RIVERSIDE DR STE 100A
MACON GA
31210-1165
US

IV. Provider business mailing address

109 LATHAM DR APT 14
WARNER ROBINS GA
31088-0711
US

V. Phone/Fax

Practice location:
  • Phone: 800-701-0498
  • Fax:
Mailing address:
  • Phone: 980-422-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: