Healthcare Provider Details

I. General information

NPI: 1154442242
Provider Name (Legal Business Name): CANDACE GRAHAM ROBINSON AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CANDACE RENEE GRAHAM

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 RITCHIE HWY STE 136A
PASADENA MD
21122-1030
US

IV. Provider business mailing address

18310 MONTGOMERY VILLAGE AVE STE 520
GAITHERSBURG MD
20879-3554
US

V. Phone/Fax

Practice location:
  • Phone: 410-590-9462
  • Fax: 410-590-9464
Mailing address:
  • Phone: 301-977-6317
  • Fax: 301-977-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00744
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: