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Individual

CANDACE RAELYNN BANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
8361 N 95TH AVE, PEORIA, AZ 85345-7717
(623) 412-4825
Mailing address
4114 N 28TH ST APT 3042, PHOENIX, AZ 85016-5943
(504) 453-4174

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5035807
AZ

Other

Enumeration date
09/01/2017
Last updated
09/01/2017
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