MEDICARE: CANDRICE A THUL PH.D.

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	103T00000X	Psychologist	3664	NC

General Provider Information

NPI Number	:	1811323306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDRICE A THUL PH.D.

Provider Business Mailing Address
First Line	:	123 CLINTON AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-2456
Country	:	US
Telephone Number	:	828-242-1347
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 CLINTON AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-2456
Country	:	US
Telephone Number	:	828-242-1347
Fax Number	:

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	09/17/2013

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