Provider Demographics
NPI:1487085742
Name:FLADGER, CANDACE STEWART (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:STEWART
Last Name:FLADGER
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 BOONE HILL RD STE C
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-2490
Mailing Address - Country:US
Mailing Address - Phone:843-875-4161
Mailing Address - Fax:
Practice Address - Street 1:1325 BOONE HILL RD STE C
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-2490
Practice Address - Country:US
Practice Address - Phone:843-875-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4639235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist