Doctor Name: | DR. KRISTIN ANI CANDAN |
NPI Number: | 1174851778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 018316 |
Business Practice Address: | 7559 263rd St Rap Program Glen Oaks, NY - 110041150 |
Business Phone Number: | 7184704238 |
Business Fax Number: | 7184708131 |
Mailing Address: | 7559 263rd St, Rap Program GLEN OAKS |
State: | NY |
Postal Code: | 110041150 |
Phone Number: | 7184704238 |
Fax Number: | 7184708131 |
NPI Enumeration Date: | 11/20/2009 |
NPI Last Update Date: | 11/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 018316 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |