Provider Demographics
NPI:1841614393
Name:VALENTINE, CANDY (SLP)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4636
Mailing Address - Country:US
Mailing Address - Phone:419-671-1200
Mailing Address - Fax:419-671-1260
Practice Address - Street 1:5555 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4636
Practice Address - Country:US
Practice Address - Phone:419-671-1200
Practice Address - Fax:419-671-1260
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 6635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist