Provider Demographics
NPI:1811555303
Name:DAILEY, CANDICE ELIZABETH
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:ELIZABETH
Last Name:DAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9998 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1157
Mailing Address - Country:US
Mailing Address - Phone:443-277-6679
Mailing Address - Fax:
Practice Address - Street 1:310 GENESIS WAY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1762
Practice Address - Country:US
Practice Address - Phone:410-544-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist