Provider Demographics
NPI:1811543523
Name:CZARNECKI, CANDICE ELAINE
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:ELAINE
Last Name:CZARNECKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:ELAINE
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:266 WINONA TER
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-5250
Mailing Address - Country:US
Mailing Address - Phone:702-752-8129
Mailing Address - Fax:
Practice Address - Street 1:266 WINONA TER
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-5250
Practice Address - Country:US
Practice Address - Phone:702-752-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-18
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician