Provider Demographics
NPI:1033257563
Name:SOLLNER, CANDICE PATRICIA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:PATRICIA
Last Name:SOLLNER
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 1:2645 S DUNDEE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7539
Mailing Address - Country:US
Mailing Address - Phone:813-842-1166
Mailing Address - Fax:813-842-1166
Practice Address - Street 1:3501 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8901
Practice Address - Country:US
Practice Address - Phone:813-837-1083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FLSA8545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist