Kandyce Ivory Wilson

NPI #1902496342 in Rocky River, Ohio

Provider Information

NPI Number: 1902496342
Entity Type: Individual
Name: Kandyce Ivory Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Jan 20, 2021
Last Updated: Jan 20, 2021

Practice Location

Address: 1692 LAKEVIEW AVE
City: Rocky River
State: Ohio
ZIP Code: 44116-2443
Phone: (216) 760-3563

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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