Martin, Candace M

Martin, Candace M is an individual health care provider with primary practice located at 1061 Harmon Ave Ste 1D03 Winn Army Community Hospital, Fort Stewart GA 31314-5674. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Martin, Candace M can be contacted via phone (912) 767-7301.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1D03 Winn Army Community Hospital Fort Stewart GA 31314-5674
Phone: (912) 767-7301
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 26854 Texas

Profile Details

NPI number 1245261627
LBN Legal business name Martin, Candace M
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Sep 9th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245261627 NPPES
Texas Other 87071A BCBS
Texas MEDICAID 165912003 BCBS

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