Provider Demographics
NPI:1730201849
Name:STEEL, CANDICE MICHELLE (BS SLP)
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:MICHELLE
Last Name:STEEL
Suffix:
Gender:F
Credentials:BS SLP
Other - Prefix:MISS
Other - First Name:CANDICE
Other - Middle Name:MICHELLE
Other - Last Name:GRIECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS SLP
Mailing Address - Street 1:4631 W KIMBERLY WAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4424
Mailing Address - Country:US
Mailing Address - Phone:480-216-2182
Mailing Address - Fax:623-516-8121
Practice Address - Street 1:4650 W SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304
Practice Address - Country:US
Practice Address - Phone:602-347-2600
Practice Address - Fax:602-347-2701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL4574251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)