Provider Demographics
NPI:1912013681
Name:MCCANDLESS, TIFFANY D (AUDIOLOGIST)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:D
Last Name:MCCANDLESS
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8014
Mailing Address - Country:US
Mailing Address - Phone:812-473-2060
Mailing Address - Fax:812-476-5118
Practice Address - Street 1:607 DUBOIS ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1048
Practice Address - Country:US
Practice Address - Phone:812-473-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002100A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN30072090Medicaid
IN200137100AMedicaid
IN200137100AMedicaid