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NPI 1972625390

NPI 1972625390 : HELEN CECELIA MCCANDLISH PTA : WESTERVILLE, OH

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General NPI Number Information
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    NPI Number           |    1972625390
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    Entity Type          |    Individual 
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    Provider Name        |    HELEN CECELIA MCCANDLISH PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/05/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    682 BAY DR 
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    City                 |    WESTERVILLE
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    State                |    OH
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    Zip                  |    43082-7491
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    Country              |    US
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    Telephone            |    614-212-2693
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    Fax                  |    614-891-6153
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Provider Business Mailing Address
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    Address Line         |    682 BAY DR 
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    City                 |    WESTERVILLE
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    State                |    OH
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    Zip                  |    43082-7491
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    Country              |    US
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    Telephone            |    614-212-2693
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    Fax                  |    614-891-6153
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    1190
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    License Number State |    OH
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