Individual provider · Type 1 NPI
Candace Holly Mack, OTR/L
Specialist · Winters, CA
NPI number
1114204849
Active
Practice location
428 Main St
Winters, CA 95694-1830
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 12045 (CA) |
| Early Intervention Provider Agency | 252Y00000X | 12045 (CA) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
About NPI 1114204849
Candace Holly Mack, OTR/L's National Provider Identifier is 1114204849, issued on Nov 9, 2011. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Winters, CA. The record was last updated on Nov 9, 2011.