MEDICARE: CANDIUS ELLIOTT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1316881337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDIUS ELLIOTT

Provider Business Mailing Address
First Line	:	2918 TYLER ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3319
Country	:	US
Telephone Number	:	248-201-8696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2918 TYLER ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3319
Country	:	US
Telephone Number	:	248-201-8696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2026
Last Update Date	:	04/18/2026

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Directions to “ CANDIUS ELLIOTT ” Practice Location

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