MEDICARE: CANDICE CROFFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	5478	SC

General Provider Information

NPI Number	:	1083035380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE CROFFORD

Provider Business Mailing Address
First Line	:	269 TORSLANDA LN
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-7042
Country	:	US
Telephone Number	:	843-900-1345
Fax Number	:

Provider Business Practice Location Address
First Line	:	269 TORSLANDA LN
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-7042
Country	:	US
Telephone Number	:	843-900-1345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	03/23/2025

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Directions to “ CANDICE CROFFORD ” Practice Location

Language	Start Address	Practice Location

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