| Doctor Name: | MARCOS CHRISTIAN CANDIA |
| NPI Number: | 1043406572 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS-CCC-SLP |
| License Number: | 2004014080 |
| Business Practice Address: | 13190 S Outer 40 Chesterfield, MO - 630175917 |
| Business Phone Number: | 3149911193 |
| Business Fax Number: | |
| Mailing Address: | 711 Autumn Glen Ln, WENTZVILLE |
| State: | MO |
| Postal Code: | 633853070 |
| Phone Number: | 6363275448 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 09/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2004014080 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |