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Individual

CANDACE GANDULLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC-SLP

Contact information

Practice address
450 MYRTLE AVE, PORT JEFFERSON, NY 11777-1739
(631) 474-3400
Mailing address
14 HAMPTON ST, HAUPPAUGE, NY 11788-2210
(914) 943-8408

Taxonomy

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

Other

Enumeration date
12/16/2014
Last updated
12/20/2016
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