Provider Demographics
NPI:1861839367
Name:MARZETT, CANDACE DAWN
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:DAWN
Last Name:MARZETT
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 1:2213 N ZENITH AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2234
Mailing Address - Country:US
Mailing Address - Phone:918-693-0870
Mailing Address - Fax:
Practice Address - Street 1:2213 N ZENITH AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-2234
Practice Address - Country:US
Practice Address - Phone:918-693-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling