Provider Demographics
NPI:1326702960
Name:DWYER, HILARY HOPE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:HOPE
Last Name:DWYER
Suffix:
Gender:F
Credentials: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:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:MC GRAW
Mailing Address - State:NY
Mailing Address - Zip Code:13101-0053
Mailing Address - Country:US
Mailing Address - Phone:772-940-9811
Mailing Address - Fax:
Practice Address - Street 1:1710 ROUTE 13
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-9648
Practice Address - Country:US
Practice Address - Phone:607-758-5209
Practice Address - Fax:607-758-5429
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031314235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist