Provider Demographics
NPI:1538855721
Name:REEL, CANDICE DANELLE
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:DANELLE
Last Name:REEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RICE MINE RD N APT C202
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3256
Mailing Address - Country:US
Mailing Address - Phone:951-490-9994
Mailing Address - Fax:
Practice Address - Street 1:150 RICE MINE RD N APT C202
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3256
Practice Address - Country:US
Practice Address - Phone:951-490-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist