Basic Information
| Provider Information | |||||||||
| NPI: | 1417381393 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRIEGEL | ||||||||
| FirstName: | CANDACE | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9940 W UNION HILLS DR | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853731673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239330022 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9940 W UNION HILLS DR | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239330022 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2013 | ||||||||
| LastUpdateDate: | 04/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 115479 | TX | N | Other Service Providers | Specialist | 225XP0019X | OTH-008790 | AZ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | 225X00000X | OTH-008790 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.