Provider Demographics
NPI:1790720191
Name:MCCAFFREY, CANDACE S (PHD)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:S
Last Name:MCCAFFREY
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 1:510 24TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5106
Mailing Address - Country:US
Mailing Address - Phone:405-329-7923
Mailing Address - Fax:405-329-8815
Practice Address - Street 1:510 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5106
Practice Address - Country:US
Practice Address - Phone:405-329-7923
Practice Address - Fax:405-329-8815
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK520103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical