Individual
CANDICE NEGLEY-TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
1111 W CENTRE AVE, PORTAGE, MI 49024-5317
(269) 324-0301
(269) 324-2387
Mailing address
1111 W CENTRE AVE, PORTAGE, MI 49024-5317
(269) 324-0301
(269) 324-2387
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
1601000484
MI
237700000X
Hearing Instrument Specialist
1601000484
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1601000484
MI STATE LICENSE NUMBER
MI
Enumeration date
11/15/2007
Last updated
03/14/2008
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