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Candice Waller, LPC-MHSP
Professional Counselor in Tucson, Arizona
NPI 1588138911

Candice Waller is a Professional Counselor based in Tucson, AZ and is specialized in Professional. Candice Waller practices in Tucson, AZ and has the professional credentials of LPC-MHSP. The NPI Number for Candice Waller is 1588138911 and holds a License No. LPC0000004067 (Arizona).

The current practice location address for Candice Waller is 5055 E Broadway Blvd Ste C104, Tucson, AZ and can be reached out via phone at 520-623-9833 and via fax at 520-923-9083.

Location: 5055 E Broadway Blvd Ste C104, Tucson, AZ, 85741-4952
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Provider Profile Details
NPI Number
1588138911
Provider Name
Candice Waller
Credential
LPC-MHSP
Provider Entity Type
Individual
Gender
Female
Address
5055 E Broadway Blvd Ste C104, Tucson, AZ, 85741-4952
Phone Number
520-623-9833
Fax Number
520-923-9083
Provider Enumeration Date
01/18/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPC-19614 01 AZ LICENSE
institution
Provider Business Practice Location Address Details
Address
5055 E Broadway Blvd Ste C104
City
State
Zip
85711-3641
Phone Number
520-623-9833
Fax Number
520-923-9083
person
Provider Business Mailing Address Details
Address
5055 E Broadway Blvd Ste C104
City
State
Zip
85711-3641
Phone Number
520-623-9833
Fax Number
520-923-9083
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC-19614 (Arizona)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LPC0000004067 (Tennessee)
Definition
Definition to come...
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