Candice Rae Guillen, IBCLC
Individual provider Active NPI Counselor · Edgewood, NM
NPI 1831669019 · NPPES record last updated Oct 24, 2024
Key facts
- NPI
- 1831669019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 26 Range Rd
Edgewood, NM 87015-9028 - Phone
- (505) 916-4020
- NPI assigned
- Nov 29, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
26 Range Rd
Edgewood, NM 87015-9028
Mailing address
26 Range Rd
Edgewood, NM 87015-9028
Phone (505) 916-4020
Other practice location 1
172A County Line Rd
Edgewood, NM 87015-7834
Phone (505) 916-4020
Other names
- Candice Rae Padilla
Other providers in Edgewood, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.