Provider Demographics
NPI:1881141497
Name:VELEZ GONZALEZ, CANDY NICOLLE (MS SLP)
Entity type:Individual
Prefix:
First Name:CANDY
Middle Name:NICOLLE
Last Name:VELEZ GONZALEZ
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1410
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1410
Mailing Address - Country:US
Mailing Address - Phone:787-239-7111
Mailing Address - Fax:
Practice Address - Street 1:57 AVE. 65 INFANTERIA
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-239-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist