Provider Demographics
NPI:1801509153
Name:WOO, CANDICE (PHD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:WOO
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 1:15 E 26TH ST APT 9CD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1505
Mailing Address - Country:US
Mailing Address - Phone:917-628-1612
Mailing Address - Fax:
Practice Address - Street 1:156 5TH AVE STE 1234
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7739
Practice Address - Country:US
Practice Address - Phone:917-628-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020160103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical