KANDYCE IVORY WILSON NPI 1902496342

NPI Information

Kandyce Ivory Wilson is a peer specialist in Rocky River, OH. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Kandyce Ivory Wilson NPI is 1902496342. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1692 LAKEVIEW AVE
ROCKY RIVER, OH
ZIP 44116-443
Phone: (216) 760-3563

The enumeration date for this NPI number is 1/20/2021 and was last updated on 1/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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