Provider Demographics
NPI:1063000370
Name:BROWN, CANDICE LEE
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:WILBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6825 E ILIFF AVE # 2-207
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2543
Mailing Address - Country:US
Mailing Address - Phone:720-595-1973
Mailing Address - Fax:
Practice Address - Street 1:6825 E ILIFF AVE # 2-207
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2543
Practice Address - Country:US
Practice Address - Phone:720-595-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst