Individual
CANDACE GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
909 17TH ST, FAIRBURY, NE 68352-1215
(402) 729-3808
Mailing address
909 17TH ST, FAIRBURY, NE 68352-1215
(402) 729-3808
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1698
NE
235Z00000X
Speech-Language Pathologist
22131
CA
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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