Provider Demographics
NPI:1366171894
Name:BENDER-DEE, CANDIDA ANN (LISAC-0748)
Entity type:Individual
Prefix:
First Name:CANDIDA
Middle Name:ANN
Last Name:BENDER-DEE
Suffix:
Gender:F
Credentials:LISAC-0748
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 W THUNDERBIRD RD STE F640
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4691
Mailing Address - Country:US
Mailing Address - Phone:480-300-6065
Mailing Address - Fax:855-923-0899
Practice Address - Street 1:5750 W THUNDERBIRD RD STE F640
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4691
Practice Address - Country:US
Practice Address - Phone:480-300-6065
Practice Address - Fax:855-923-0899
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-0748101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)