Provider Demographics
NPI:1437250842
Name:MAUST, CANDIDA KATHRYN
Entity Type:Individual
Prefix:MISS
First Name:CANDIDA
Middle Name:KATHRYN
Last Name:MAUST
Suffix:
Gender:F
Credentials:
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Mailing Address - Street 1:USAMEDDAC WUERZBURG ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:UNIT 26610
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:US
Mailing Address - Phone:01149931-804-3616
Mailing Address - Fax:01149931-804-3241
Practice Address - Street 1:USAMEDDAC WUERZBURG EDIS CLINIC ANSBACH
Practice Address - Street 2:235TH BSB UNIT 28614
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09177
Practice Address - Country:US
Practice Address - Phone:01149098-118-3811
Practice Address - Fax:01149098-118-3854
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOT10733225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN