Provider Demographics
NPI:1104133578
Name:STORY, CANDISE ELIZABETH (BA, BS)
Entity type:Individual
Prefix:MRS
First Name:CANDISE
Middle Name:ELIZABETH
Last Name:STORY
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Gender:F
Credentials:BA, BS
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Mailing Address - Street 1:1201 ARLINGTON ST
Mailing Address - Street 2:SUITE G.
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4072
Mailing Address - Country:US
Mailing Address - Phone:580-332-6851
Mailing Address - Fax:580-310-6047
Practice Address - Street 1:1201 ARLINGTON ST
Practice Address - Street 2:SUITE G
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4072
Practice Address - Country:US
Practice Address - Phone:580-332-6851
Practice Address - Fax:580-310-6047
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health