Provider Demographics
NPI:1902347990
Name:TOUBO, CANDACE L (MA, LP, NCC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:L
Last Name:TOUBO
Suffix:
Gender:F
Credentials:MA, LP, NCC
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:L
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:111 HAZEL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 HAZEL LN STE 300
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1253
Practice Address - Country:US
Practice Address - Phone:412-749-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional