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General NPI Number Information
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NPI Number | 1851642532
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Entity Type | Individual
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Provider Name | CARMEN CANDELARIO M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 350 AVE FONT MARTELO OFICINA 202
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City | HUMACAO
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State | PR
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Zip | 00791-3266
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Country | US
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Telephone | 787-597-8707
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Fax |
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Provider Business Mailing Address
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Address Line | 56 CALLE MIMOSA URB. EL ROCIO
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City | CAYEY
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State | PR
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Zip | 00736-4881
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Country | US
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Telephone | 787-597-8707
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2528
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 609
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License Number State | PR
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