Provider Demographics
NPI:1982224754
Name:THOMAS, CANDACE MICHELLE (SLP-CFY)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:MICHELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6706 WESTMORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4624
Mailing Address - Country:US
Mailing Address - Phone:202-617-0577
Mailing Address - Fax:
Practice Address - Street 1:LUDLOW-TAYLOR ELEMENTARY SCHOOL
Practice Address - Street 2:659 G STREET, NE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2000
Practice Address - Country:US
Practice Address - Phone:202-617-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLPCF000067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist