Provider Demographics
NPI:1013500990
Name:YOUAKIM, CANDACE JOY (MS, SLP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:JOY
Last Name:YOUAKIM
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:JOY
Other - Last Name:JANKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:235 CAVALIER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-6510
Mailing Address - Country:US
Mailing Address - Phone:352-238-5657
Mailing Address - Fax:
Practice Address - Street 1:9074 BAY DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2223
Practice Address - Country:US
Practice Address - Phone:352-403-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA19235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty