Provider Demographics
NPI:1184209348
Name:HARMON-UTER, CANDACE MARIE
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:MARIE
Last Name:HARMON-UTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WATKINS PARK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1627
Mailing Address - Country:US
Mailing Address - Phone:240-423-0530
Mailing Address - Fax:
Practice Address - Street 1:55 WATKINS PARK DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1627
Practice Address - Country:US
Practice Address - Phone:240-423-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist