Provider Demographics
NPI:1427472679
Name:BISHOP, CANDIES (QASP-S)
Entity type:Individual
Prefix:
First Name:CANDIES
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:QASP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S SWOOPE AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5786
Mailing Address - Country:US
Mailing Address - Phone:407-928-0444
Mailing Address - Fax:
Practice Address - Street 1:533 N NOVA RD STE 204
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4422
Practice Address - Country:US
Practice Address - Phone:386-898-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1427472679OtherNPI