Provider Demographics
NPI:1629392535
Name:GENEST, CANDACE MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:MICHELLE
Last Name:GENEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 PRESTON RD
Mailing Address - Street 2:SUITE #240
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5869
Mailing Address - Country:US
Mailing Address - Phone:972-377-2446
Mailing Address - Fax:
Practice Address - Street 1:7010 PRESTON RD
Practice Address - Street 2:SUITE #240
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5869
Practice Address - Country:US
Practice Address - Phone:972-377-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34511103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical