Provider Demographics
NPI:1427873363
Name:QUINONES, CANDICE
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:
Last Name:QUINONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 HUGHEY SQUARE CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3692
Mailing Address - Country:US
Mailing Address - Phone:718-219-1982
Mailing Address - Fax:
Practice Address - Street 1:2252 HUGHEY SQUARE CT
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3692
Practice Address - Country:US
Practice Address - Phone:718-219-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator