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NPI Code Detail

MEDICARE: CANDICE HALL-BRUCE

MEDICARE:   CANDICE  HALL-BRUCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1043924152
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE HALL-BRUCE
Provider Business Mailing Address
First Line : 675 PONCE DE LEON AVE NE UNIT W338
Second Line :
City : ATLANTA
State : GA
Zip : 30308-3912
Country : US
Telephone Number : 678-751-8491
Fax Number :
Provider Business Practice Location Address
First Line : 675 PONCE DE LEON AVE NE UNIT W338
Second Line :
City : ATLANTA
State : GA
Zip : 30308-3912
Country : US
Telephone Number : 678-751-8491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2023
Last Update Date : 01/12/2023

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Directions to “ CANDICE HALL-BRUCE ” Practice Location

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