Provider Demographics
NPI:1891566196
Name:ROBINSON, CANDICE DIANE (BS, NCPT4)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:DIANE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:BS, NCPT4
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 S ROXBORO ST APT D
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2928
Mailing Address - Country:US
Mailing Address - Phone:336-549-7099
Mailing Address - Fax:
Practice Address - Street 1:2314 S ROXBORO ST APT D
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2928
Practice Address - Country:US
Practice Address - Phone:336-549-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171400000XOther Service ProvidersHealth & Wellness Coach
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information