Provider Demographics
NPI:1306366166
Name:DESHLER, CANDACE LUCENE (LPMT, MT-BC)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:LUCENE
Last Name:DESHLER
Suffix:
Gender:F
Credentials:LPMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 OGLETHORPE PROFESSIONAL CT STE C
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3693
Mailing Address - Country:US
Mailing Address - Phone:912-349-1219
Mailing Address - Fax:
Practice Address - Street 1:106 OGLETHORPE PROFESSIONAL CT STE C
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3693
Practice Address - Country:US
Practice Address - Phone:912-349-1219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000168225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist