Individual
SUZANNE BETH CANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 189S, SAINT PAUL, MN 55114-1052
(651) 332-7474
(651) 332-7475
Mailing address
2550 UNIVERSITY AVE W, SUITE 189S, SAINT PAUL, MN 55114-1052
(651) 332-7474
(651) 332-7475
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
LP3830
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266P0CA
BLUE CROSS
MN
01
—
61-71476
MEDICA
MN
01
—
981231016105
PREFERRED ONE
MN
Enumeration date
08/04/2006
Last updated
07/08/2007
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