Provider Demographics
NPI:1184877755
Name:DE CANDIA, MARIA R (TSHH)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:R
Last Name:DE CANDIA
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24445 88TH RD
Mailing Address - Street 2:BELLEROSE
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1609
Mailing Address - Country:US
Mailing Address - Phone:718-962-2604
Mailing Address - Fax:718-962-2604
Practice Address - Street 1:24445 88TH RD
Practice Address - Street 2:BELLEROSE
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1609
Practice Address - Country:US
Practice Address - Phone:718-962-2604
Practice Address - Fax:718-962-2604
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTSHH CERTIFICATE2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant