| Candace D Benner | |
|
19871 Sackett Ln Waynesville MO 65583-3510 | |
| (573) 315-3848 | |
| (573) 312-3848 |
| Full Name | Candace D Benner |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 19871 Sackett Ln, Waynesville, Missouri |
| Authorized Official Name and Position | Candace D Benner (OWNER/TRAUMA SPECIALIST) |
| Authorized Official Contact | 5733153848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Candace D Benner Po Box 114 Roby MO 65557-0114 Ph: (573) 315-3448 | Candace D Benner 19871 Sackett Ln Waynesville MO 65583-3510 Ph: (573) 315-3848 |
| NPI Number | 1518547918 |
|---|---|
| Provider Enumeration Date | 04/09/2021 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518547918 | NPI | - | NPPES |
| 1467869156 | Other | MO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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