Provider Demographics
NPI:1912460635
Name:MALLOY, CANDICE BROOKE
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:BROOKE
Last Name:MALLOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1027 COAL HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 4TH AVE
Practice Address - Street 2:
Practice Address - City:CURWENSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16833-1070
Practice Address - Country:US
Practice Address - Phone:814-236-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist