Provider Demographics
NPI:1245089358
Name:LYNCH, CANDICE S (ND)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:S
Last Name:LYNCH
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4630 S LAKESHORE DR APT 104
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7167
Mailing Address - Country:US
Mailing Address - Phone:561-713-0636
Mailing Address - Fax:
Practice Address - Street 1:670 N 54TH ST STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1529
Practice Address - Country:US
Practice Address - Phone:480-331-2630
Practice Address - Fax:602-883-8116
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath