MEDICARE: CANDICE CARRIERE

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1932708666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE CARRIERE

Provider Business Mailing Address
First Line	:	211 TERRACE CREEK CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3590
Country	:	US
Telephone Number	:	832-771-5716
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 TERRACE CREEK CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3590
Country	:	US
Telephone Number	:	832-771-5716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	10/23/2020

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Directions to “ CANDICE CARRIERE ” Practice Location

Language	Start Address	Practice Location

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