Provider Demographics
NPI:1134390719
Name:O'CONNELL, CANDY KATHLEEN (MA,CCC-A)
Entity type:Individual
Prefix:
First Name:CANDY
Middle Name:KATHLEEN
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 VANCE DR STE 225
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2133
Mailing Address - Country:US
Mailing Address - Phone:303-431-8881
Mailing Address - Fax:303-431-8564
Practice Address - Street 1:7850 VANCE DR STE 225
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2133
Practice Address - Country:US
Practice Address - Phone:303-431-8881
Practice Address - Fax:303-431-8564
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO263237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04008389Medicaid
COCF8286OtherRAILROAD MEDICARE
CO04008389Medicaid