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General NPI Number Information
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NPI Number | 1689189136
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Entity Type | Individual
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Provider Name | CANDIS E-NAE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 4401 CONNER ST
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City | DETROIT
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State | MI
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Zip | 48215-2201
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Country | US
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Telephone | 313-273-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 830 N SUMMIT ST STE 2
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City | TOLEDO
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State | OH
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Zip | 43604-1884
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Country | US
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Telephone | 419-693-9600
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Fax | 419-693-9650
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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