Basic Information
| Provider Information | |||||||||
| NPI: | 1992095046 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALIZIO | ||||||||
| FirstName: | CANDICE | ||||||||
| MiddleName: | WOODS | ||||||||
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| Credential: | MA, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1750 ELM ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031042919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038651769 | ||||||||
| FaxNumber: | 6036287757 | ||||||||
| Practice Location | |||||||||
| Address1: | 1750 ELM ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031042919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038651769 | ||||||||
| FaxNumber: | 6036287757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2011 | ||||||||
| LastUpdateDate: | 03/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 0187 | NH | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.