Provider Demographics
NPI:1992995369
Name:CANDELA, GIRLIE NUNEZ (OTR/ L)
Entity type:Individual
Prefix:MRS
First Name:GIRLIE
Middle Name:NUNEZ
Last Name:CANDELA
Suffix:
Gender:F
Credentials:OTR/ L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 L H POLK ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-5010
Mailing Address - Country:US
Mailing Address - Phone:856-558-3265
Mailing Address - Fax:
Practice Address - Street 1:1154 L H POLK ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-5010
Practice Address - Country:US
Practice Address - Phone:856-558-3265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00374100225X00000X
AROTR2128225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist