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General NPI Number Information
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NPI Number | 1710748207
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Entity Type | Organization
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Legal Business Name | CANDACE WALTERS AND ASSOCIATES
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 105 FIR ST. #327 SAC ANNEX BLDG.
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City | LA GRANDE
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State | OR
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Zip | 97850-2663
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Country | US
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Telephone | 541-246-3638
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Fax | 360-844-5184
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Provider Business Mailing Address
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Address Line | 60117 HWY 203
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City | UNION
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State | OR
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Zip | 97883-9521
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Country | US
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Telephone | 360-210-7301
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Fax | 360-844-5184
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Authorized Official
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Title or Position | OFFICE MANAGER/BILLING
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Name | AMY L YOUNG
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Credential |
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Telephone | 360-210-7301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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