Provider Demographics
NPI:1013214386
Name:KEIM, CANDICE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:KEIM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-8575
Mailing Address - Country:US
Mailing Address - Phone:866-425-5768
Mailing Address - Fax:888-308-1147
Practice Address - Street 1:231 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-8575
Practice Address - Country:US
Practice Address - Phone:866-425-5768
Practice Address - Fax:888-308-1147
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4677235Z00000X
NC9351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist