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General NPI Number Information
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NPI Number | 1235548587
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Entity Type | Individual
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Provider Name | CANDACE RIKA MINAMI CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 17100 E SHEA BLVD STE 600
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-6663
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Country | US
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Telephone | 480-837-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 2032 E WINDSONG DR
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City | PHOENIX
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State | AZ
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Zip | 85048-8124
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Country | US
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Telephone | 423-258-2031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA8775
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP8775
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License Number State | AZ
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