Provider Demographics
NPI:1922329523
Name:NEIL, CANDYCE (BS)
Entity Type:Individual
Prefix:
First Name:CANDYCE
Middle Name:
Last Name:NEIL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 RIDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-3529
Mailing Address - Country:US
Mailing Address - Phone:217-840-2377
Mailing Address - Fax:
Practice Address - Street 1:609 RIDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-3529
Practice Address - Country:US
Practice Address - Phone:217-840-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker