Provider Demographics
NPI:1619218138
Name:CANDELARIA, ERIKA LEAH (MS SPL)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LEAH
Last Name:CANDELARIA
Suffix:
Gender:F
Credentials:MS SPL
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 270440
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-2440
Mailing Address - Country:US
Mailing Address - Phone:787-306-5929
Mailing Address - Fax:
Practice Address - Street 1:CARR 866, LOTE 51
Practice Address - Street 2:CANDELARIA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-796-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist