Provider Demographics
NPI:1366755688
Name:BILTZ, CANDACE R (AUD)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:R
Last Name:BILTZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:R
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1810 MACKENZIE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2967
Mailing Address - Country:US
Mailing Address - Phone:614-273-2234
Mailing Address - Fax:
Practice Address - Street 1:1810 MACKENZIE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2967
Practice Address - Country:US
Practice Address - Phone:614-273-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01750231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist