Provider Demographics
NPI:1699067454
Name:MANELA, CANDACE A (MA)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:A
Last Name:MANELA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLBY AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084
Mailing Address - Country:US
Mailing Address - Phone:856-361-2710
Mailing Address - Fax:
Practice Address - Street 1:1 COLBY AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1000
Practice Address - Country:US
Practice Address - Phone:856-361-2710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health