Provider Demographics
NPI:1972883338
Name:ARKON, CANDICE CAMILLE
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:CAMILLE
Last Name:ARKON
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 1:923 E 80 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-5774
Mailing Address - Country:US
Mailing Address - Phone:435-862-4147
Mailing Address - Fax:
Practice Address - Street 1:1726 BUCKLEY LN
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5031
Practice Address - Country:US
Practice Address - Phone:801-373-6562
Practice Address - Fax:801-375-9225
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health