Provider Demographics
NPI:1932679693
Name:VANBUHLER, CANDACE (CTRS)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:VANBUHLER
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54531 JEFFERY DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5815
Mailing Address - Country:US
Mailing Address - Phone:586-872-0329
Mailing Address - Fax:
Practice Address - Street 1:54531 JEFFERY DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5815
Practice Address - Country:US
Practice Address - Phone:586-872-0329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist