Provider Demographics
NPI:1689949570
Name:ANNIS, KANDICE K (LPC, NCC, LCDCI)
Entity Type:Individual
Prefix:MRS
First Name:KANDICE
Middle Name:K
Last Name:ANNIS
Suffix:
Gender:F
Credentials:LPC, NCC, LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 W COUNTY ROAD 6714
Mailing Address - Street 2:
Mailing Address - City:NATALIA
Mailing Address - State:TX
Mailing Address - Zip Code:78059-2313
Mailing Address - Country:US
Mailing Address - Phone:210-259-5037
Mailing Address - Fax:
Practice Address - Street 1:480 W COUNTY ROAD 6714
Practice Address - Street 2:
Practice Address - City:NATALIA
Practice Address - State:TX
Practice Address - Zip Code:78059-2313
Practice Address - Country:US
Practice Address - Phone:210-259-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional