Provider Demographics
NPI:1740316264
Name:SIEGEL, CANDY (PHD)
Entity type:Individual
Prefix:DR
First Name:CANDY
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 E FORT LOWELL RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1518
Mailing Address - Country:US
Mailing Address - Phone:520-299-5485
Mailing Address - Fax:
Practice Address - Street 1:2828 E FORT LOWELL RD BLDG B
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1518
Practice Address - Country:US
Practice Address - Phone:520-299-5485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ991103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical