Provider Demographics
NPI:1245414952
Name:CANUPP, DOROTHY CANDACE (BSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CANDACE
Last Name:CANUPP
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BARNADO RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-8463
Mailing Address - Country:US
Mailing Address - Phone:864-429-3066
Mailing Address - Fax:864-582-7111
Practice Address - Street 1:206 BARNADO RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-8463
Practice Address - Country:US
Practice Address - Phone:864-429-3066
Practice Address - Fax:864-582-7111
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator