Provider Demographics
NPI:1437510583
Name:BILLINGS, CANDACE V (LAC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:V
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 JOHNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-4605
Mailing Address - Country:US
Mailing Address - Phone:901-481-2093
Mailing Address - Fax:
Practice Address - Street 1:3710 JOHNWOOD DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-4605
Practice Address - Country:US
Practice Address - Phone:901-481-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist