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General NPI Number Information
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NPI Number | 1386861060
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Entity Type | Individual
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Provider Name | CANDACE KIMBERLY EDDY M.S.W., LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 650 EDISON WAY
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City | RENO
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State | NV
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Zip | 89502-4100
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Country | US
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Telephone | 775-284-4717
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Fax | 775-284-4595
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Provider Business Mailing Address
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Address Line | PO BOX 2424
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City | RENO
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State | NV
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Zip | 89505-2424
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Country | US
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Telephone | 775-287-3196
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Fax | 775-284-4595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5685-C
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License Number State | NV
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