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General NPI Number Information
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NPI Number | 1619218138
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Entity Type | Individual
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Provider Name | ERIKA LEAH CANDELARIA MS SPL
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | CARR 866, LOTE 51 CANDELARIA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-796-1100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270440
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City | SAN JUAN
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State | PR
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Zip | 00928-2440
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Country | US
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Telephone | 787-306-5929
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1221
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License Number State | PR
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