Provider Demographics
NPI:1891905089
Name:ZIEMBA, CANDAS (MA)
Entity Type:Individual
Prefix:
First Name:CANDAS
Middle Name:
Last Name:ZIEMBA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30998 29TH ST
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-8427
Mailing Address - Country:US
Mailing Address - Phone:269-655-5871
Mailing Address - Fax:
Practice Address - Street 1:241 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1320
Practice Address - Country:US
Practice Address - Phone:269-655-5871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007703101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor